J Dent Res:疼痛敏感性改变了与损伤相关的颞下颌关节疾病的风险 

2020-04-12 MedSci原创 MedSci原创

本研究评估了颌骨损伤和实验性疼痛敏感性对疼痛性颞下颌关节紊乱(TMD)风险的影响。

本研究评估了颌骨损伤和实验性疼痛敏感性对疼痛性颞下颌关节紊乱(TMD)风险的影响。

 

分析数据来自于口面疼痛:前瞻性评估和风险评估(OPPERA)的嵌套病例对照研究。在409名入组时没有TMD的美国成年人的社区样本中,对损伤和随后的疼痛性TMD发病情况≤5年的进行了前瞻性监测。

 

基线时期,使用定量感觉测试来测量热压力和针刺痛的敏感性,作为潜在的效应修饰剂。随访期间,使用季度(3个月一次)健康更新问卷调查,确定了9种潜在外伤事件中的任何一种颌骨损伤。研究检查人员对疼痛性TMD进行了分类,得出233例病例和176例配对对照组。使用Logistic回归模型、估计的发病率比(IORs)和95%的置信度(CLs)分析损伤和疼痛性TMD发病之间的关联。

 

结果显示,随访期间,38.2%的病例和13.1%的对照组病例报告了1次或更多的损伤,而这些损伤的内在因素(例如,持续张口或打哈欠)是外因(如牙科就诊、鞭伤)的4倍。外在因素造成的损伤(IOR = 7.6;95% CL,1.6-36.2)、持续张口(IOR = 5.4;95% CL,2.4-12.2)和打哈欠(IOR = 3.4;95% CL,1.6-7.3)与TMD发病率增加有关。单次伤害(IOR = 6.0; 95% CL,2.9-12.4)和多发伤害(IOR = 9.4; 95% CL,3.4,25.6)预测疼痛性TMD的发生率均高于非损伤性的事件(IOR = 1.9; 95% CL,1.1-3.4)。与热痛敏感度低的人(IOR = 3.9; 95% CL, 1.7-8.4)相比,热痛敏感度高的人(IOR = 7.4; 95% CL, 3.1-18.0)损伤相关的疼痛性TMD风险升高。

 

该研究结果表明,颌骨损伤与疼痛性TMD风险的升高密切相关,并且在入组时对热痛敏感性增强的受试者中,该风险被放大。在判断下颌骨损伤预后重要性时,不应忽视常见但看似无害的事件,如打哈欠等。

 

原始出处

 

S SharmaR Ohrbach, et al., Pain Sensitivity Modifies Risk of Injury-Related Temporomandibular Disorder. J Dent Res, 22034520913247

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    2020-04-21 fengyi819
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    2020-11-24 xlysu
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本研究的目的是比较四种非手术保守方法治疗颞下颌关节紊乱(TMD)的疗效。

J Oral Rehabil:歌手更易得TMD吗?

荷兰的一项研究显示,在调整了所建模型中潜在的混杂变量后,研究者发现唱歌行为本身与颞下颌关节紊乱病(TMD)疼痛和颞下颌关节(TMJ)弹响无关。该论文2019年7月18日在线发表于《口腔康复学杂志》(J Oral Rehabil)。

J Oral Rehabil:系统性回顾,青少年TMD相关研究仍不足

瑞典的一项研究显示,目前普遍缺乏关于儿童或者青少年的颞下颌关节紊乱病疼痛情况的标准化研究,很显然这还需要进一步系统地进行患病率和治疗效果的评价。考虑到这一点,现在还不能为患有颞下颌关节紊乱病(TMD)的儿童和青少年制定任何有依据的治疗策略或指南。该论文2018年12月26日在线发表于《口腔康复学杂志》(J Oral Rehabil)。