de Wijer A, de Leeuw J R, Steenks M H, Bosman F
Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, Faculty of Medicine, Utrecht University, The Netherlands.
Spine (Phila Pa 1976). 1996 Jul 15;21(14):1638-46. doi: 10.1097/00007632-199607150-00005.
The authors assessed the results of an anamnestic self-administered questionnaire given to 111 patients with temporomandibular disorders and 103 patients with cervical spine disorders.
The present study was performed to investigate whether patients with cervical spine disorders and subgroups of patients with temporomandibular disorders differ regarding specific and accompanying signs and symptoms of temporomandibular disorders and cervical spine disorders.
Patients with temporomandibular disorders frequently show signs and symptoms related to cervical spine disorders, and, vice versa, patients with cervical spine disorders may show signs and symptoms related to temporomandibular disorders. Many authors have pointed out the existence of neuroanatomical and biomechanical relationships.
The questionnaire included questions about pain, symptoms of temporomandibular disorders, accompanying signs and symptoms, psychosocial factors, and general health. Before their clinical examination, all patients were requested by mail to complete the questionnaire.
Patients with cervical spine disorders reported fewer symptoms of temporomandibular disorders than the subgroups of patients with temporomandibular disorders, more general health symptoms than patients with temporomandibular disorders with an arthrogenous or myogenous component, and fewer ear symptoms than patients with temporomandibular disorders. There was no difference between the patient groups regarding other associated signs and symptoms and psychosocial factors as measured with the questionnaire. Logistic regression analyses showed that six variables (jaws, ears, eyes, temporomandibular joint sounds, complaints of the shoulders, and pain in joints other than the temporomandibular joint) correctly classified 91% of the patients as having temporomandibular disorders or cervical spine disorders.
The results of this study do not support the theoretical concept that cervical spine disorders may give rise to temporomandibular disorders. The authors' results indicate that the anamnestic questionnaire can be used as an aid to distinguish patients with cervical spine disorders from subgroups of patients with temporomandibular disorders.
作者评估了一项回忆性自填问卷的结果,该问卷发放给了111例颞下颌关节紊乱症患者和103例颈椎疾病患者。
本研究旨在调查颈椎疾病患者以及颞下颌关节紊乱症患者亚组在颞下颌关节紊乱症和颈椎疾病的特定及伴随体征和症状方面是否存在差异。
颞下颌关节紊乱症患者常表现出与颈椎疾病相关的体征和症状,反之,颈椎疾病患者也可能表现出与颞下颌关节紊乱症相关的体征和症状。许多作者指出了神经解剖学和生物力学关系的存在。
问卷包括有关疼痛、颞下颌关节紊乱症症状、伴随体征和症状、心理社会因素以及总体健康状况的问题。在临床检查前,所有患者均通过邮件被要求完成问卷。
颈椎疾病患者报告的颞下颌关节紊乱症症状少于颞下颌关节紊乱症患者亚组,总体健康症状多于具有关节源性或肌源性成分的颞下颌关节紊乱症患者,耳部症状少于颞下颌关节紊乱症患者。根据问卷测量,患者组在其他相关体征和症状以及心理社会因素方面没有差异。逻辑回归分析显示,六个变量(颌部、耳部、眼睛、颞下颌关节弹响、肩部主诉以及颞下颌关节以外关节的疼痛)将91%的患者正确分类为患有颞下颌关节紊乱症或颈椎疾病。
本研究结果不支持颈椎疾病可能引发颞下颌关节紊乱症的理论概念。作者的结果表明,回忆性问卷可作为一种辅助手段,用于区分颈椎疾病患者和颞下颌关节紊乱症患者亚组。