PREVALENCE OF TEMPOROMANDIBULAR DISORDERS AMONG ORTHODONTIC PATIENTS (CROSS-SECTIONAL CLINICAL SURVEY)

Manar Souhail Youssef, A. Tarabaih, A. Osman
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Abstract

Orthodontic treatment as a risk factor for the development of temporomandibular disorders (TMD) has been a controversy in literature. The aim of this study was to evaluate the prevalence of TMD, as defined in the Diagnostic Criteria (DC)/TMD Axis II, among orthodontic patients. A cross-sectional study (N=180) consisted of 3 groups: 60 control patients seeking orthodontic consultation, 60 patients undergoing orthodontic treatment for 3-5 months, 60 patients undergoing orthodontic treatment for 10-14 months. Patients answered a structured questionnaire that rated their oral parafunctions according to the Oral Behavior Checklist (OBC), pain intensity levels according to the Graded Chronic Pain Scale (GCPS), jaw functional limitations according to the Jaw Functional Limitation Scale 20 (JFLS-20), psychosocial factors (PHQ-9) and somatization levels (PHQ-15). The Chi Square test showed a statistically significant difference p-value=0.001 among both active orthodontic groups (3-5 months/10-14 months) regarding masticatory limitation (53.3%), vertical mobility limitation (41.7% for 3-5 months and 55.0% 10-14 months) and verbal & emotional expression limitation (53.3% 3-5 months and 66.7% 10-14 months). The findings revealed that as orthodontic treatment progresses, the limitation increases. Moreover, no statistical significance was observed between the three groups regarding oral parafunctional habits, chronic pain levels, psychosocial status and somatization. Orthodontic treatment is not a major factor associated with the symptoms of the TMD. Further prospective studies are needed to evaluate the true role of orthodontic treatment in the development of TMD.
正畸患者颞下颌疾病患病率(横断面临床调查)
正畸治疗作为颞下颌疾病(TMD)发展的危险因素在文献中一直存在争议。本研究的目的是评估正畸患者中TMD的患病率,根据诊断标准(DC)/TMD轴II的定义。横断面研究(N=180)分为3组:对照组60例就诊正畸,60例治疗3-5个月,60例治疗10-14个月。患者回答了一份结构化问卷,根据口腔行为检查表(OBC)对其口腔功能进行评分,根据分级慢性疼痛量表(GCPS)对疼痛强度进行评分,根据颌骨功能限制量表20 (JFLS-20)对其颌骨功能限制进行评分,心理社会因素(PHQ-9)和躯体化水平(PHQ-15)。卡方检验显示,两组(3-5个月/10-14个月)在咀嚼限制(53.3%)、垂直活动限制(3-5个月41.7%,10-14个月55.0%)、言语和情绪表达限制(3-5个月53.3%,10-14个月66.7%)方面的差异有统计学意义(p值=0.001)。结果表明,随着正畸治疗的进展,限制增加。此外,在口腔功能习惯、慢性疼痛水平、心理社会状况和躯体化方面,三组之间没有统计学意义。正畸治疗不是与TMD症状相关的主要因素。需要进一步的前瞻性研究来评估正畸治疗在TMD发展中的真正作用。
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