The Initial Treatment Plan Versus the Actually Performed Treatment of Patients With Temporomandibular Disorders in the First 6 Months After the Initial Visit.

IF 3.1 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of oral rehabilitation Pub Date : 2025-07-01 DOI:10.1111/joor.70012

Kaylee van Ee, Magdalini Thymi, Naichuan Su, Michail Koutris, Thiprawee Chattrattrai, Frank Lobbezoo

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引用次数: 0

Abstract

Background: Temporomandibular disorders (TMD) can impact on daily life, and are therefore important to treat with a fitting therapy. However, the factors that may influence the received treatment remain unknown.

Objectives: To investigate the deviation between the indicated and received TMD treatment, and to identify patient and clinician characteristics that could influence the received treatment and the deviation from indicated treatment.

Methods: This retrospective cohort study collected data on the indicated and received treatment of 140 TMD patients. The treatment modalities were counselling, occlusal appliance (OA), physical therapy, psychological treatment, contingent electrical stimulation, ecological momentary assessment and medication. Potential predictors for receiving treatment and deviation from indicated treatment included patient-related factors such as TMD diagnosis, bruxism, psychosocial factors and clinician-related factors such as clinician's specialty level and experience.

Results: A good to perfect agreement between indicated and received treatments was observed for all treatment (84.3%-100%), except psychological treatment (66.4%). Received OA was associated with having a pain diagnosis (OR [95% CI] = 2.596 [1.189, 5.669], p = 0.017). In addition, received physical therapy was significantly associated with a pain diagnosis (OR [95% CI] = 3.876 [1.401, 10.721], p = 0.009), awake bruxism (OR [95% CI] = 1.730 (1.112, 2.690), p = 0.015) and clinician's level-being staff (OR [95% CI] = 6.068 [1.729, 20.553], p = 0.016). Received psychological therapy was significantly associated with a pain diagnosis (OR [95% CI] = 4.013 [1.077, 14.951], p = 0.038), sleep bruxism (OR [95% CI] = 1.381 [1.041, 1.830], p = 0.025), and physical symptoms (OR [95% CI] = 2.578 [1.561, 4.259], p < 0.001). No significant predictors were found for deviation.

Conclusion: Receiving TMD treatment was associated with both patient-related factors-such as a TMD diagnosis, bruxism and physical symptoms-and clinician-related factors, such as the clinician's level of experience.

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颞下颌疾病患者初次就诊后6个月的初始治疗计划与实际治疗的比较

背景：颞下颌紊乱（TMD）会影响日常生活，因此采用合适的治疗方法非常重要。然而，可能影响所接受治疗的因素仍然未知。目的：探讨TMD的指征治疗与实际治疗之间的偏差，并确定可能影响接受治疗和偏离指征治疗的患者和临床医生特征。方法：本回顾性队列研究收集了140例TMD患者的指征和接受治疗的资料。治疗方式有咨询、咬合矫治器（OA）、物理治疗、心理治疗、偶发电刺激、生态瞬时评估和药物治疗。接受治疗和偏离指示治疗的潜在预测因素包括患者相关因素，如TMD诊断、磨牙、心理社会因素和临床医生相关因素，如临床医生的专业水平和经验。结果：除心理治疗（66.4%）外，所有治疗的适应症与实际治疗的吻合度为84.3% ~ 100%。接受OA与疼痛诊断相关（OR [95% CI] = 2.596 [1.189, 5.669], p = 0.017）。此外，接受物理治疗与疼痛诊断（OR [95% CI] = 3.876 [1.401, 10.721], p = 0.009）、清醒磨牙（OR [95% CI] = 1.730 (1.112, 2.690), p = 0.015）和临床医生级别的工作人员（OR [95% CI] = 6.068 [1.729, 20.553], p = 0.016）显著相关。接受心理治疗与疼痛诊断（OR [95% CI] = 4.013 [1.077, 14.951], p = 0.038）、睡眠磨牙（OR [95% CI] = 1.381 [1.041, 1.830], p = 0.025）、身体症状(OR [95% CI] = 2.578 [1.561, 4.259]， p结论：接受TMD治疗与患者相关因素（如TMD诊断、磨牙和身体症状）和临床相关因素（如临床医生的经验水平）均相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of oral rehabilitation 医学-牙科与口腔外科

CiteScore

5.60

自引率

10.30%

发文量

116

审稿时长

4-8 weeks

期刊介绍： Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.