Risk and Health Factors for Temporomandibular Disorders Following Radiotherapy for Head and Neck Cancer

IF 4 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of oral rehabilitation Pub Date : 2025-07-21 DOI:10.1111/joor.70019

Ellie Saghafi, Kalid Kadhim, Birgitta Johansson-Cahlin, Charlotte Andrén Andås, Therese Karlsson, Caterina Finizia, Göran Kjeller, Lisa Tuomi

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Abstract

Background

Temporomandibular disorders (TMD) are multifactorial and complex musculoskeletal conditions frequently associated with pain or dysfunction, including impaired jaw function and pain in the temporomandibular joint, masticatory muscles and/or related structures. Recent studies have found that personality, behaviour and environment can affect the development of TMD.

Objective

This study investigates whether patient-related factors can predict TMD among patients with head and neck cancer (HNC) after radiotherapy.

Methods

We randomised 58 consecutive patients with squamous cell carcinoma in the head and neck area into two groups: training with a jaw mobiliser once a day or a control group (no training). A comprehensive examination for TMD was conducted at baseline (before oncologic treatment) and 6 and 12 months after radiotherapy. Potential predictors were analysed using linear and logistic regression analyses.

Results

Myalgia was associated with TMD diagnosis at baseline, and jaw exercise lowered the risk of developing myalgia at the follow-ups. The degree of pain at baseline and jaw exercise were associated with the changes in pain at follow-ups. Jaw exercise was associated with a lower degree of pain. A high degree of pain at baseline was associated with less pain at follow-ups. Jaw exercise was associated with a reduced risk of decreased maximal incisal mouth opening post treatment.

Conclusion

No psychosocial or other background factor reduced risk for myalgic pain or pain to the same degree as jaw exercise. Therefore, we recommend using jaw training to prevent the deterioration of maximal incisal opening and the development of pain associated with TMD.

Abstract Image

查看原文本刊更多论文

头颈癌放疗后颞下颌紊乱的危险和健康因素。

背景：颞下颌紊乱（TMD）是多因素和复杂的肌肉骨骼疾病，通常与疼痛或功能障碍有关，包括颌骨功能受损和颞下颌关节、咀嚼肌和/或相关结构的疼痛。最近的研究发现，性格、行为和环境都会影响TMD的发展。目的：探讨患者相关因素能否预测头颈癌（HNC）放疗后TMD的发生。方法：我们将58例连续头颈部鳞状细胞癌患者随机分为两组：每天一次下颌活动器训练或对照组（不训练）。在基线（肿瘤治疗前）和放疗后6个月和12个月对TMD进行全面检查。使用线性和逻辑回归分析分析潜在的预测因素。结果：肌痛在基线时与TMD诊断相关，下颌运动降低了随访时发生肌痛的风险。基线疼痛程度和下颌运动与随访时疼痛的变化有关。下颌运动与较低程度的疼痛有关。基线时疼痛程度高与随访时疼痛程度低相关。下颌运动与治疗后最大切口开口减少的风险降低有关。结论：没有任何社会心理或其他背景因素可以降低肌痛或与颌骨运动相同程度的疼痛的风险。因此，我们建议使用下颌训练来防止最大切开口的恶化和TMD相关疼痛的发展。

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.