Temporomandibular Disorders in Brain Injury Patients and Diagnostic Accuracy of the Assessment Tools.

IF 2.9 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Oral diseases Pub Date : 2025-07-01 Epub Date: 2025-02-10 DOI:10.1111/odi.15281

Mohit Kothari, Silas Alves-Costa, Abhishek Kumar, Gustavo G Nascimento, Jørgen Feldbæk Nielsen, Peter Svensson, Simple F Kothari

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Abstract

Objectives: To evaluate the presence, severity and progression of temporomandibular disorders (TMD) in acquired brain injury (ABI) population and determine the diagnostic accuracy of 3Q/TMD and Fonseca Anamnestic Index (FAI) against the gold standard, Diagnostic Criteria for TMD (DC/TMD).

Methods: ABI individuals were assessed using 3Q/TMD and FAI at admission (n = 73) and Week 4 (n = 52), while DC/TMD was conducted only at Week 4. Diagnostic accuracy, sensitivity and specificity of 3Q/TMD and FAI were calculated against DC/TMD.

Results: TMD was detected in 66.0% (3Q/TMD) and 27.8% (FAI) at admission, with mild (75%) to moderate (25%) severity which was mostly pain-related. TMD frequency decreased to 11.3% (3Q/TMD) and 17.3% (FAI) by Week 4. Accuracy rates were 0.82 for 3Q/TMD and 0.83 for FAI. Sensitivity was 0.33 (3Q/TMD) and 0.50 (FAI), while specificity was high at 0.93 (3Q/TMD) and 0.90 (FAI).

Conclusions: TMD presence was higher in an ABI population compared to the general population however the frequency decreased over time. The high specificity and accuracy of 3Q/TMD and FAI indicate their potentials as screening tools but their low sensitivity limits their effectiveness in identifying all TMD cases. Patients with ABI should be assessed for TMD as part of their comprehensive care.

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脑损伤患者颞下颌紊乱及评估工具的诊断准确性。

目的：评价获得性脑损伤（ABI）人群颞下颌紊乱（temporomandibular disorders， TMD）的存在、严重程度和进展情况，并对照金标准TMD诊断标准（DC/TMD）确定3Q/TMD和Fonseca记忆指数（FAI）的诊断准确性。方法：在入院时（n = 73）和第4周（n = 52）使用3Q/TMD和FAI对ABI个体进行评估，而DC/TMD仅在第4周进行。对比DC/TMD计算3Q/TMD和FAI的诊断准确性、敏感性和特异性。结果：入院时TMD检出率分别为66.0% （3Q/TMD）和27.8% (FAI)，轻（75%）至中度（25%）严重程度以疼痛相关为主。到第4周，TMD频率下降到11.3% （3Q/TMD）和17.3% （FAI）。3Q/TMD的准确率为0.82，FAI的准确率为0.83。敏感性分别为0.33 （3Q/TMD）和0.50 (FAI)，特异性分别为0.93 （3Q/TMD）和0.90 （FAI）。结论：与一般人群相比，ABI人群中TMD的发生率更高，但频率随着时间的推移而降低。3Q/TMD和FAI的高特异性和准确性表明了它们作为筛查工具的潜力，但它们的低灵敏度限制了它们在识别所有TMD病例中的有效性。ABI患者应接受TMD评估，作为其综合护理的一部分。

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

Oral diseases 医学-牙科与口腔外科

CiteScore

7.60

自引率

5.30%

发文量

325

审稿时长

4-8 weeks

期刊介绍： Oral Diseases is a multidisciplinary and international journal with a focus on head and neck disorders, edited by leaders in the field, Professor Giovanni Lodi (Editor-in-Chief, Milan, Italy), Professor Stefano Petti (Deputy Editor, Rome, Italy) and Associate Professor Gulshan Sunavala-Dossabhoy (Deputy Editor, Shreveport, LA, USA). The journal is pre-eminent in oral medicine. Oral Diseases specifically strives to link often-isolated areas of dentistry and medicine through broad-based scholarship that includes well-designed and controlled clinical research, analytical epidemiology, and the translation of basic science in pre-clinical studies. The journal typically publishes articles relevant to many related medical specialties including especially dermatology, gastroenterology, hematology, immunology, infectious diseases, neuropsychiatry, oncology and otolaryngology. The essential requirement is that all submitted research is hypothesis-driven, with significant positive and negative results both welcomed. Equal publication emphasis is placed on etiology, pathogenesis, diagnosis, prevention and treatment.