Kaylee van Ee, Magdalini Thymi, Naichuan Su, Michail Koutris, Thiprawee Chattrattrai, Frank Lobbezoo
{"title":"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","authors":"Kaylee van Ee, Magdalini Thymi, Naichuan Su, Michail Koutris, Thiprawee Chattrattrai, Frank Lobbezoo","doi":"10.1111/joor.70012","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Initial Treatment Plan Versus the Actually Performed Treatment of Patients With Temporomandibular Disorders in the First 6 Months After the Initial Visit.\",\"authors\":\"Kaylee van Ee, Magdalini Thymi, Naichuan Su, Michail Koutris, Thiprawee Chattrattrai, Frank Lobbezoo\",\"doi\":\"10.1111/joor.70012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":16605,\"journal\":{\"name\":\"Journal of oral rehabilitation\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of oral rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/joor.70012\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of oral rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/joor.70012","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
The Initial Treatment Plan Versus the Actually Performed Treatment of Patients With Temporomandibular Disorders in the First 6 Months After the Initial Visit.
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.
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.
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