The Association Between the Central Sensitisation Inventory and Temporomandibular Disorders Is Confounded by Migraine, Depression, Widespread Pain and Parafunction. A Cross-Sectional Telehealth Study

IF 3.1 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of oral rehabilitation Pub Date : 2024-09-17 DOI:10.1111/joor.13852

Letícia Bojikian Calixtre, Hedwig Aleida van der Meer, Corine Mirjam Visscher, Ana Beatriz de Oliveira, Daniela Aparecida de Godoi Gonçalves

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Abstract

Background

Temporomandibular disorders (TMDs) are conditions that involve the temporomandibular joints, masticatory muscles, and associated tissues, causing orofacial pain. Central sensitisation (CS) is a relevant part of the TMD pathophysiology. Migraine, psychological aspects, parafunctional oral habits and widespread pain are commonly associated with both TMD and CS and could confound the association between them.

Objectives

To investigate the association between painful TMD and the Central Sensitisation Inventory (CSI) score, and to assess the presence of confounders in this association.

Methods

Cross-sectional study that assessed women with and without orofacial pain complaints using telehealth. The TMD Pain Screener and an online physical examination determined the presence of painful TMD. The following questionnaires were applied: CSI, Headache Screening Questionnaire, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Oral Behavior Checklist, Jaw Functional Limitation Scale and the Nordic musculoskeletal questionnaire. A single regression investigated the association between the CSI score and TMD, and a multiple regression investigated the effect of the other outcomes as possible confounders. Confounding was considered present when the association between TMD and the CSI score changed more than 10% after adding a possible confounder to the regression model.

Results

Forty-two women with painful TMD and 53 without TMD were included. There was a significant association between the CSI score and the presence of painful TMD (R² = 0.639; p < 0.001). This association changed when the following outcomes were added to the model: presence of migraine, symptoms of depression, widespread pain and parafunctional oral habits.

Conclusion

The positive association between TMD and the CSI score was confounded by migraine, symptoms of depression, widespread pain and parafunctional oral habits.

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中枢敏感性量表与颞下颌关节紊乱之间的关系受偏头痛、抑郁、广泛性疼痛和副功能的影响。一项跨部门远程保健研究

背景颞下颌关节紊乱症（TMD）是一种涉及颞下颌关节、咀嚼肌和相关组织的疾病，会引起口面部疼痛。中枢敏化（CS）是 TMD 病理生理学的一个相关部分。偏头痛、心理问题、副功能性口腔习惯和广泛性疼痛通常与 TMD 和 CS 相关，可能会混淆两者之间的联系。方法横断面研究通过远程保健对有和无口面部疼痛主诉的女性进行评估。通过 TMD 疼痛筛查器和在线体检确定是否存在 TMD 疼痛。采用了以下调查问卷：CSI、头痛筛查问卷、广泛性焦虑症-7、患者健康问卷-9、口腔行为检查表、下颌功能限制量表和北欧肌肉骨骼问卷。单一回归研究了 CSI 评分与 TMD 之间的关联，多元回归研究了其他结果作为可能混杂因素的影响。如果在回归模型中加入可能的混杂因素后，TMD 与 CSI 评分之间的关系变化超过 10%，则认为存在混杂因素。CSI 评分与是否存在疼痛性 TMD 之间存在明显关联（R2 = 0.639; p < 0.001）。结论 TMD 与 CSI 评分之间的正相关受到偏头痛、抑郁症状、广泛性疼痛和辅助功能性口腔习惯的影响。

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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.