Journal of oral rehabilitation最新文献_第10页

Stress-, Anxiety-, and Gender-Related Modulation of Masseter Muscle Activity During Wakefulness 清醒时咬肌活动的压力、焦虑和性别相关调节。

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

Journal of oral rehabilitation

Pub Date : 2025-10-15 DOI: 10.1111/joor.70077

Suvichaya Angkulmahasuk, Akira Nishiyama, Hiroyuki Ishiyama, Kenji Fueki

Background

Psychological stress and anxiety are known to influence muscle activity, particularly in the masticatory system. However, the interactive effects of stress, trait anxiety, and gender on objective masseter muscle activity remain poorly understood.

Objectives

This study investigates the association between psychological factors, stress and trait anxiety, as well as gender, and masseter muscle activity during various tasks designed to induce stress or relaxation.

Methods

Thirty-four healthy participants (16 males, 18 females; mean age 28.1 ± 3.1 years) were recruited. Trait anxiety was assessed using the State–Trait Anxiety Inventory (STAI-Y2), and stress levels were measured using a Visual Analog Scale (VAS). Participants completed four randomised tasks (reading, video-watching, math-solving, bead-grabbing) over two experimental days while wearing a wireless EMG logger to record masseter muscle activity. Main outcomes included burst frequency (per hour), wave peak value (%MVC), and integral activity (%MVC·s). Linear mixed models assessed the effects of stress, trait anxiety, and gender. Self-reported oral behaviours (partial Oral Behaviour Checklist; POBC) were also evaluated.

Results

Stress significantly reduced burst frequency (−3.5% per unit; p = 0.016) and wave peak value (−1.9% per unit; p < 0.001) in males but not females. Low-anxiety individuals exhibited increased integral muscle activity with rising stress (+4.8% per unit; p = 0.002), while other groups showed no such trend. Trait anxiety positively correlated with POBC scores (r_s = 0.409, p = 0.016).

Conclusions

Masseter muscle activity is differentially modulated by stress, anxiety, and gender. These findings highlight the psychophysiological complexity underlying stress-related oral parafunctional behaviours and support individualised assessment approaches.

背景：已知心理压力和焦虑会影响肌肉活动，特别是咀嚼系统。然而，压力、特质焦虑和性别对客观咬肌活动的相互作用仍然知之甚少。目的：本研究探讨心理因素、压力、特质焦虑、性别与咬肌活动在各种诱导压力或放松任务中的关系。方法：招募34名健康受试者，男16名，女18名，平均年龄28.1±3.1岁。使用状态-特质焦虑量表（STAI-Y2）评估特质焦虑，使用视觉模拟量表（VAS）测量压力水平。在为期两天的实验中，参与者完成了四项随机任务（阅读、观看视频、解题、抓头），同时佩戴了一个无线肌电记录器来记录咬肌的活动。主要结果包括突发频率（每小时）、波峰值（%MVC）和积分活动（%MVC·s）。线性混合模型评估了压力、特质焦虑和性别的影响。自我报告的口腔行为（部分口腔行为检查表；POBC）也被评估。结果：应力显著降低突发频率（-3.5% /单位，p = 0.016）和峰值（-1.9% /单位，p = 0.409, p = 0.016）。结论：咬肌活动受压力、焦虑和性别的差异调节。这些发现强调了与压力相关的口腔功能行为的心理生理复杂性，并支持个性化的评估方法。

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引用次数: 0

Analysis of the Current Status and Influencing Factors of Oral Frailty in Community-Dwelling Older Adults 社区老年人口腔衰弱现状及影响因素分析。

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

Journal of oral rehabilitation

Pub Date : 2025-10-14 DOI: 10.1111/joor.70081

Mingzhu Lu, Yiming Wei, Ruili Zhang, Huijuan Li

Background

The prevalence of oral frailty is high in older adults in China. Older adults in the community may be more likely to ignore the impact of slight changes in oral function in daily life.

Objectives

To analyse the current status and influencing factors of oral frailty.

Methods

In this cross-sectional study, 361 community-dwelling older adults aged ≥ 60 years in four districts of Shijiazhuang were selected as the research objects by convenience sampling method. The number of natural teeth, times of daily teeth brushing, and the Oral Health Assessment Scale for the elderly were used to assess oral frailty.

Results

The prevalence of oral frailty among community-dwelling older adults was 33.4%. Logistic regression analysis showed that older age (70–79 years old compared to 60–69 years old: OR = 2.255, 95% CI: 1.044–4.871; ≥ 80 years old compared to 60–69 years old: OR = 3.644, 95% CI: 1.634–8.123), wearing dentures (OR = 4.625, 95% CI: 2.590–8.259), posterior occlusion pairs < 5 pairs (OR = 8.849, 95% CI: 4.423–17.706), not flossing (OR = 4.870, 95% CI: 1.752–13.540), and not gargling (OR = 2.128, 95% CI: 1.206–3.754) could increase the risk of oral frailty in the community-dwelling older adults. Wearing dentures was a protective factor for oral frailty in older adults with < 20 teeth (OR = 0.704, 95% CI: 0.530–0.935).

Conclusions

The prevalence of oral frailty in older adults in the community is 33.4%, which is at an intermediate level of the reported prevalence in China (17.1%–59.2%), but still higher than that in Japan (20.0%). Older adults who are older, have less than 20 teeth without dentures, have less than five pairs of posterior occlusal pairs, do not use dental floss, and do not gargle are at high risk of oral frailty and should be paid attention to.

背景：中国老年人口腔虚弱的患病率较高。社区中的老年人可能更容易忽视日常生活中口腔功能的轻微变化所带来的影响。目的：分析口腔虚弱的现状及影响因素。方法：采用横断面研究方法，采用方便抽样法，选取石家庄市4个区361名≥60岁的社区居住老年人作为研究对象。采用自然牙数、每日刷牙次数和老年人口腔健康评估量表评估口腔脆弱程度。结果：社区老年人口腔虚弱患病率为33.4%。Logistic回归分析显示年龄较大(70-79岁比较60-69岁：OR = 2.255, 95% CI: 1.044-4.871；结论：社区老年人口腔脆弱患病率为33.4%，与中国报告的患病率（17.1% ~ 59.2%）处于中等水平，但仍高于日本（20.0%）。年龄较大、无假牙少于20颗、后咬合对少于5对、不使用牙线、不漱口的老年人是口腔脆弱的高危人群，应引起重视。

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引用次数: 0

Immunohistochemical Profiling in Temporomandibular Disorders: A Systematic Review of Biomarker Patterns in Synovial Tissue 颞下颌疾病的免疫组织化学分析：滑膜组织生物标志物模式的系统回顾。

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

Journal of oral rehabilitation

Pub Date : 2025-10-10 DOI: 10.1111/joor.70079

Pascal Eber, Yannick M. Sillmann, Ana M. P. Baggio, Philippe Korn, David A. Keith, Shruti Handa, Fernando P. S. Guastaldi

Background

Temporomandibular disorders (TMD) are multifactorial conditions involving biomechanical dysfunction and progressive degeneration of the temporomandibular joint (TMJ) and surrounding tissues. Although affecting up to 36% of the population, their underlying molecular mechanisms remain incompletely understood. Immunohistochemical analysis of synovial biomarkers may help clarify processes involved in tissue degeneration and symptom development.

Objective

This systematic review investigates associations between immunohistochemical biomarkers in synovial tissue and morphological or symptomatic findings in TMD, with a focus on internal derangement and disc displacement.

Methods

A comprehensive literature search was conducted in MEDLINE/PubMed, EMBASE, Web of Science, and selected journals. Studies were screened according to PRISMA guidelines, and methodological quality was assessed using the Newcastle-Ottawa Scale. Due to heterogeneity across studies, a narrative synthesis was performed.

Results

Thirteen studies involving 493 patients (mean age: 42.2 years; 82% women) were included, analyzing 23 different biomarkers. Frequently examined markers included MMPs, COX-2, iNOS, interleukins, and VEGF. Several of these showed statistically significant correlations with histological, radiological, or clinical findings, suggesting roles in joint homeostasis, inflammation, and tissue remodeling associated with TMD.

Conclusion

Based on the reported associations with histological, radiological, and clinical findings, biomarkers were categorised into stage-specific and functional groups, underscoring their relevance for disease stratification and prognosis. By revealing disease-related patterns in progression and severity, synovial biomarkers have the potential to empower our understanding of the underlying mechanisms of TMD and contribute to more precise diagnostic and therapeutic approaches.

背景：颞下颌关节紊乱（TMD）是一种多因素疾病，涉及颞下颌关节（TMJ）及其周围组织的生物力学功能障碍和进行性退行性变。尽管影响到36%的人口，但其潜在的分子机制仍然不完全清楚。滑膜生物标志物的免疫组织化学分析可能有助于阐明涉及组织变性和症状发展的过程。目的：本系统综述探讨滑膜组织免疫组织化学生物标志物与TMD形态学或症状表现之间的关系，重点关注内部紊乱和椎间盘移位。方法：在MEDLINE/PubMed、EMBASE、Web of Science及精选期刊中进行综合文献检索。根据PRISMA指南筛选研究，并使用纽卡斯尔-渥太华量表评估方法学质量。由于研究的异质性，我们进行了叙事综合。结果：纳入了13项研究，涉及493例患者（平均年龄：42.2岁，82%为女性），分析了23种不同的生物标志物。经常检查的标记物包括MMPs、COX-2、iNOS、白细胞介素和VEGF。其中一些与组织学、放射学或临床表现有统计学意义的相关性，提示与TMD相关的关节稳态、炎症和组织重塑的作用。结论：基于已报道的与组织学、放射学和临床表现的关联，生物标志物被分为特定阶段和功能组，强调了它们与疾病分层和预后的相关性。通过揭示疾病进展和严重程度的相关模式，滑膜生物标志物有可能增强我们对TMD潜在机制的理解，并有助于更精确的诊断和治疗方法。

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引用次数: 0

Suprahyoid Muscle Strengthening Using a Novel Exercise Device in Older Adults With Oral Hypofunction: A Randomised Placebo-Controlled Trial 使用一种新型运动装置强化舌骨上肌治疗老年口腔功能减退：一项随机安慰剂对照试验。

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

Journal of oral rehabilitation

Pub Date : 2025-10-10 DOI: 10.1111/joor.70070

Ji-Su Park, Gihyoun Lee, Moon-Young Chang

Background

Strengthening of the suprahyoid muscles plays a critical role in swallowing rehabilitation for older adults with oral hypofunction. Therefore, the development of diverse exercise devices and the accumulation of evidence supporting their effectiveness are essential.

Objective

The aim of this study was to evaluate the effectiveness of a novel neck-collar exercise device designed to strengthen the suprahyoid muscles in older adults with oral hypofunction.

Methods

Thirty older adults with oral hypofunction were enrolled and randomly assigned to the experimental or placebo group. The experimental group performed suprahyoid muscle-strengthening exercises using the neck-collar device developed for this study. The exercises incorporated isometric and isotonic movements. The placebo group performed the same exercises using a sham device identical in appearance but lacking an internal resistance spring, thus providing minimal resistance. The primary outcomes were suprahyoid muscle activation, recorded using surface electromyography with bipolar electrodes placed submentally, and suprahyoid muscle thickness, measured on ultrasound images. The secondary outcome was swallowing function, evaluated using videofluoroscopic swallowing studies and scored using the penetration-aspiration scale.

Results

The experimental group showed significantly greater improvements in suprahyoid muscle activation and thickness, along with significantly lower penetration-aspiration scale scores than the placebo group (all p < 0.05).

Conclusion

These findings suggest that the novel neck-collar exercise device is effective in enhancing suprahyoid muscle activation and thickness, and in reducing the risk of airway penetration and aspiration in older adults with oral hypofunction.

背景：强化舌骨上肌在老年人口腔功能减退患者的吞咽康复中起着至关重要的作用。因此，开发多样化的运动器械并积累支持其有效性的证据至关重要。目的：本研究的目的是评估一种新型颈领运动装置的有效性，该装置旨在加强老年人口腔功能减退的舌骨上肌。方法：选取30例老年口腔功能减退患者，随机分为实验组和安慰剂组。实验组使用为本研究开发的颈领装置进行舌骨上肌肉强化练习。这些运动包括等距运动和等张力运动。安慰剂组使用外观相同但缺少内部阻力弹簧的假装置进行相同的练习，从而提供最小的阻力。主要的结果是舌骨上肌的激活，使用放置在潜意识的双极电极的表面肌电图记录，以及舌骨上肌的厚度，通过超声图像测量。次要结果是吞咽功能，使用透视吞咽研究评估，并使用穿透-吸入量表评分。结果：实验组在舌骨上肌激活和厚度方面的改善明显大于安慰剂组，穿透-吸吸量表得分明显低于安慰剂组（均p）。结论：这些发现表明，新型颈领运动装置可有效增强舌骨上肌的激活和厚度，并可降低老年口腔功能障碍患者气道穿透和吸吸的风险。

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引用次数: 0

Self-Management Therapies for Temporomandibular Disorders—Evidence From Systematic Reviews 颞下颌疾病的自我管理疗法——来自系统评价的证据。

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

Journal of oral rehabilitation

Pub Date : 2025-10-08 DOI: 10.1111/joor.70074

Tessa Bijelic, Ambrosina Michelotti, Rosaria Bucci, Daniela Del Sorbo, EwaCarin Ekberg, Birgitta Häggman-Henrikson

Objectives

Chronic pain in the orofacial region affects 10%–15% of the general population. It is most often related to temporomandibular disorders (TMD): pain in the masticatory muscles and the temporomandibular joints. Managing chronic pain conditions requires a biopsychosocial, evidence-based and patient-centred approach. Accordingly, self-management has been advocated for TMD. This umbrella review aimed to evaluate existing evidence in systematic reviews (SRs) on self-management therapy for TMD.

Methods

The review was carried out in accordance with the PRISMA and PRIOR guidelines, with a pre-registered protocol (PROSPERO CRD42021276856). PubMed, Scopus, LILACS and the Cochrane Library were searched until December 1st 2023 to identify SRs that evaluated self-management for TMD. Two independent reviewers screened titles and abstracts, performed full-text assessments, extracted all data and performed risk of bias assessment with AMSTAR 2.

Results

A total of 1740 studies were identified. After title and abstract screening, 399 studies underwent full-text assessment and 11 SRs comprising 49 unique primary studies were included. Of these, six SRs reported favorable results for self-management for TMD, whereas five reported insufficient evidence either for or against the use of self-management compared to other interventions. The overlap of primary studies between the SRs was 53%, and the main evidence gaps were related to quality of life and adverse effects outcomes. The methodological shortcomings of the SRs primarily stem from insufficient primary-study design criteria or not providing references for excluded studies.

Conclusions

Existing evidence generally suggests beneficial effects from self-management strategies such as patient education, behavioural therapy and jaw exercises.

目的：口腔面区慢性疼痛影响10%-15%的普通人群。它最常与颞下颌紊乱（TMD）有关：咀嚼肌和颞下颌关节疼痛。管理慢性疼痛状况需要一种生物心理社会、循证和以患者为中心的方法。因此，TMD提倡自我管理。本综述旨在评价系统评价（SRs）中关于TMD自我管理治疗的现有证据。方法：按照PRISMA和PRIOR指南进行审查，采用预注册方案（PROSPERO CRD42021276856）。检索PubMed， Scopus， LILACS和Cochrane图书馆，直到2023年12月1日，以确定评估TMD自我管理的sr。两名独立审稿人筛选标题和摘要，进行全文评估，提取所有数据，并使用AMSTAR 2进行偏倚风险评估。结果：共纳入1740项研究。在标题和摘要筛选后，399项研究进行了全文评估，包括49项独特的主要研究在内的11项SRs被纳入。其中，6个srr报告了TMD自我管理的有利结果，而5个报告了与其他干预措施相比，支持或反对使用自我管理的证据不足。SRs之间的初步研究重叠率为53%，主要证据缺口与生活质量和不良反应结局有关。SRs的方法学缺陷主要源于不充分的初步研究设计标准或未为被排除的研究提供参考。结论：现有证据普遍表明，自我管理策略如患者教育、行为治疗和颌部锻炼是有益的。

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引用次数: 0

Influence of Sleep and Wakefulness States and Physical Activity on Chronic Pain in Temporomandibular Disorders 睡眠、清醒状态和体力活动对颞下颌疾病慢性疼痛的影响。

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

Journal of oral rehabilitation

Pub Date : 2025-10-08 DOI: 10.1111/joor.70076

Koichiro Uno, Ryota Takaoka, Takafumi Kato, Ayumi Shintani, Shoichi Ishigaki

Background

Chronic pain in patients with temporomandibular disorders is a common and costly social problem. However, studies investigating the direct relationship between sleep and physical activity and pain are insufficient, and the causal relationship between these factors remains unclear.

Objectives

This study aimed to clarify whether sleep conditions and physical activity influence the subjective intensity of chronic pain in patients with temporomandibular disorders.

Methods

The participants consisted of 15 females (mean age: 38.9 ± 10.1 years). Physical activity and total sleep time were evaluated using the Actigraph (AW2, AMI, USA). The recordings were carried out for 14 consecutive days. Pain intensity and subjective sleep quality were also evaluated using the Visual Analogue Scale for 14 consecutive days. The linear mixed-effects model and Mann–Whitney U-test were applied for statistical analyses.

Results

The higher the subjective sleep quality the previous night, the lower the jaw pain the next day. The higher the physical activity on the previous day, the lower the jaw pain the next day. The higher the jaw pain on the previous day, the higher the jaw pain the next day.

Conclusions

The subjective intensity of jaw pain was affected by subjective sleep quality, physical activity, and jaw pain the previous day.

背景：颞下颌疾病患者的慢性疼痛是一个常见且代价高昂的社会问题。然而，调查睡眠与身体活动和疼痛之间直接关系的研究还不够，这些因素之间的因果关系尚不清楚。目的：本研究旨在阐明睡眠条件和身体活动是否影响颞下颌疾病患者慢性疼痛的主观强度。方法：女性15例，平均年龄38.9±10.1岁。使用Actigraph （AW2， AMI， USA）评估身体活动和总睡眠时间。连续14天进行记录。连续14天使用视觉模拟量表评估疼痛强度和主观睡眠质量。采用线性混合效应模型和Mann-Whitney u检验进行统计分析。结果：前一晚主观睡眠质量越高，次日下颌疼痛程度越低。前一天体力活动量越大，第二天下颌疼痛程度越低。前一天下颌疼痛程度越重，第二天下颌疼痛程度越重。结论：主观下颌疼痛强度受主观睡眠质量、体力活动和前一天下颌疼痛的影响。

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引用次数: 0

Evaluation of Temporomandibular Joint Structures and Conditions Using Dental-Dedicated MRI: A Feasibility Study 使用牙科专用MRI评估颞下颌关节结构和状况：可行性研究。

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

Journal of oral rehabilitation

Pub Date : 2025-10-07 DOI: 10.1111/joor.70071

Gabriela S. Liedke, Jennifer Christensen, Rubens Spin-Neto

Background

MRI is the most viable alternative to depict the soft tissues of the TMJ, and a recently developed dental-dedicated MRI (ddMRI) brings new possibilities to count on this technology at point-of-care.

Objectives

To evaluate the feasibility of ddMRI for the assessment of temporomandibular joint (TMJ) conditions and to compare the evaluation of bony components with that of cone-beam computed tomography (CBCT).

Methods

CBCT and ddMRI images from 24 patients were independently assessed by three observers. Each TMJ side was evaluated for hard and soft tissue conditions (soft tissues assessed only with ddMRI), including flattening, cortical erosion, subcortical sclerosis, osteophyte, subcortical cyst, loose body, disc position, and joint fluid. Inter- and intra-examiner agreement and condition prevalence were calculated for each modality. Diagnoses of bone-related TMJ conditions were compared between imaging modalities using the McNemar test (α = 0.05).

Results

The mean inter-observer agreement was 0.36 for ddMRI and 0.50 for CBCT; intra-observer agreement ranged from 0.444 to 1. The most prevalent finding was anterior disc displacement (58.3%). Bone conditions were more frequently identified on CBCT, with prevalence ranging from 2.1% (subcortical cyst) to 41.7% (flattening), compared to 0% and 31.3%, respectively, on ddMRI. In this feasibility study, no significant differences were found between CBCT and ddMRI for relevant hard tissue conditions (p > 0.05), supporting ddMRI's potential as an adjunct modality for TMJ assessment.

Conclusion

ddMRI is a feasible imaging modality for TMJ evaluation, enabling assessment of bony and soft tissue components, while avoiding ionizing radiation, which supports its potential clinical applicability.

背景：MRI是描述颞下颌关节软组织的最可行的替代方法，最近开发的牙科专用MRI （ddMRI）带来了新的可能性，可以在护理点依靠这项技术。目的：评价ddMRI评估颞下颌关节（TMJ）状况的可行性，并与锥束计算机断层扫描（CBCT）对骨成分的评估进行比较。方法：由3名观察员独立评估24例患者的CBCT和ddMRI图像。评估每个TMJ侧的软硬组织状况（仅用ddMRI评估软组织），包括扁平、皮质糜烂、皮质下硬化、骨赘、皮质下囊肿、松体、椎间盘位置和关节积液。计算每一种模式的检查者之间和检查者内部的一致性和病情患病率。采用McNemar试验比较不同影像学方式对骨相关TMJ疾病的诊断（α = 0.05）。结果：ddMRI的平均观察者间一致性为0.36，CBCT为0.50；观察员内部的一致性从0.444到1不等。最常见的是前椎间盘移位（58.3%）。骨疾病在CBCT上更常见，患病率从2.1%（皮质下囊肿）到41.7%（变平），而在ddMRI上分别为0%和31.3%。在这项可行性研究中，CBCT和ddMRI在相关硬组织条件方面没有发现显著差异（p > 0.05），支持ddMRI作为TMJ评估辅助方式的潜力。结论：ddMRI是一种可行的TMJ评估成像方式，能够评估骨和软组织成分，同时避免电离辐射，支持其潜在的临床适用性。

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引用次数: 0

Comparative Analysis of OHIP Versions for Research on Temporomandibular Disorders 颞下颌疾病研究的OHIP版本比较分析。

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

Journal of oral rehabilitation

Pub Date : 2025-10-07 DOI: 10.1111/joor.70075

Adrian Ujin Yap, Ni Luh Dewi, Emelia Syafiera, Carolina Marpaung

Background

An international team has recommended assessing oral health-related quality of life (OHRQoL) in four dimensions and using the Oral Health Impact Profile-5 (OHIP-5) for all oral health conditions.

Objectives

This study compared OHIP summary, domain, and dimension scores among individuals with no and different Temporomandibular Disorder (TMD) symptoms, examined correlations across OHIP versions, and explored the use of OHIP-5 for TMD research.

Methods

Young adults completed the Five TMD Symptoms (5Ts) screener and items from the OHIP-49, OHIP-14, OHIP-5, and OHIP-TMD. Participants were categorised into no (NT), intra-articular (IT), pain-related (PT), and combined (CT) TMD symptom groups. Data were analysed with the chi-square test and nonparametric tests, including Spearman's correlation (α = 0.05).

Results

The final sample consisted of 573 individuals (mean age 19.3 years [SD 1.3]; 82.6% women), of whom 64.0% reported NT, while 21.8%, 4.2%, and 10.0% had IT, PT, and CT symptoms, respectively. Significant differences in summary scores were consistent across participant groups (CT/PT/IT>NT; CT>IT) for all OHIP versions, though variations were observed in domain and dimension scores. Notably, no significant differences in the Psychosocial Impact dimension were identified for the OHIP-5. Summary scores for the OHIP-49 and OHIP-14 were very strongly correlated with those for OHIP-TMD, whereas the OHIP-5 demonstrated a strong correlation (r_s = 0.86–0.94).

Conclusions

A four-dimensional impact framework is suitable for use in TMD research. While the OHIP-5 can evaluate overall OHRQoL, its substitution for OHIP-14 or OHIP-TMD should be considered only when brevity is prioritised over dimension-specific assessment.

背景：一个国际团队建议从四个维度评估口腔健康相关生活质量（OHRQoL），并使用口腔健康影响概况-5 （OHIP-5）评估所有口腔健康状况。目的：本研究比较了无颞下颌障碍（TMD）症状和不同症状个体的OHIP总结、域和维度得分，检查了不同OHIP版本之间的相关性，并探讨了OHIP-5在TMD研究中的应用。方法：青年人完成TMD五种症状（5Ts）筛查和OHIP-49、OHIP-14、OHIP-5、OHIP-TMD项目。参与者被分为无（NT）、关节内（IT）、疼痛相关（PT）和联合（CT） TMD症状组。数据分析采用卡方检验和非参数检验，包括Spearman相关（α = 0.05）。结果：最终样本包括573人（平均年龄19.3岁[SD 1.3]； 82.6%为女性），其中64.0%报告NT， 21.8%、4.2%和10.0%分别有IT、PT和CT症状。所有OHIP版本的参与者组（CT/PT/IT>NT； CT>IT）的总结得分的显着差异是一致的，尽管在域和维度得分中观察到差异。值得注意的是，OHIP-5在心理社会影响维度上没有显著差异。OHIP-49和OHIP-14总分与OHIP-TMD总分呈极显著相关，而OHIP-5总分与tmd总分呈极显著相关（rs = 0.86 ~ 0.94）。结论：四维冲击框架适用于TMD研究。虽然OHIP-5可以评估整体的OHRQoL，但只有当简洁性优先于特定维度的评估时，才应该考虑替代OHIP-14或OHIP-TMD。

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引用次数: 0

Is Insomnia Linked to Sleep Bruxism in Adults? A Systematic Review and Meta-Analysis 成年人失眠与睡眠磨牙症有关吗？系统回顾和荟萃分析。

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

Journal of oral rehabilitation

Pub Date : 2025-10-04 DOI: 10.1111/joor.70068

Eduardo Machado, Jessica Klöckner Knorst, Fabrício Batistin Zanatta, Thais Perez Iglesias, Cibele Dal Fabbro, Dalva Poyares

Aim

Systematically evaluate the previous literature on the association between insomnia and sleep bruxism (SB) in adults.

Methods

Advanced searches were performed in different databases (PubMed, Embase, LILACS, Scopus and Web of Science) and grey literature until March 2025. Two trained reviewers independently conducted all stages of the review to identify observational studies evaluating the association between insomnia and SB in adults. Methodological quality was assessed using the Newcastle–Ottawa Scale (NOS). A narrative synthesis summarised the main characteristics of the included studies. Meta-analyses were performed to obtain pooled estimates separately for self-reported and polysomnography (PSG)-based SB. Available data on insomnia and SB were converted into odds ratio (OR) with corresponding 95% confidence intervals (CIs).

Results

Of the 1135 records initially identified, 931 were screened by title and abstract, and 23 were assessed in full text. Eight studies met the inclusion criteria for the systematic review, and six were eligible for meta-analysis, comprising a total sample of approximately 6990 adults. The meta-analysis of four studies investigating the association between insomnia and self-reported SB found no statistically significant association under the random-effects model (OR 1.17; 95% CI 0.79–1.72). Likewise, the pooled analysis of studies assessing PSG-based SB also showed no significant association with insomnia (OR 0.91; 95% CI 0.43–1.95).

Conclusion

Our findings indicate a lack of consistent evidence for a significant association between insomnia and SB. This conclusion is further limited by the small number of included studies, the moderate risk of bias in some studies, and the observed heterogeneity.

目的：系统评价前人关于成人失眠与睡眠磨牙症（SB）关系的文献。方法：截至2025年3月，在PubMed、Embase、LILACS、Scopus和Web of Science等不同数据库和灰色文献中进行高级检索。两名训练有素的审稿人独立进行了审查的所有阶段，以确定评估成人失眠和SB之间关系的观察性研究。采用纽卡斯尔-渥太华量表（NOS）评估方法学质量。叙述性综合总结了纳入研究的主要特点。进行meta分析，分别获得自我报告和基于多导睡眠图（PSG）的SB的汇总估计。失眠和SB的现有数据被转换为具有相应95%置信区间（ci）的比值比（OR）。结果：在初步鉴定的1135份记录中，931份通过标题和摘要筛选，23份通过全文评估。8项研究符合系统评价的纳入标准，6项研究符合荟萃分析的条件，包括大约6990名成年人的总样本。对四项调查失眠与自我报告的SB之间关系的研究进行meta分析，发现在随机效应模型下无统计学意义的关联（OR 1.17; 95% CI 0.79-1.72）。同样，评估基于psg的SB的研究的汇总分析也显示与失眠没有显著关联（OR 0.91; 95% CI 0.43-1.95）。结论：我们的研究结果表明，缺乏一致的证据表明失眠与SB之间存在显著关联。该结论进一步受到纳入研究数量少、部分研究偏倚风险适中以及观察到的异质性的限制。

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引用次数: 0

Relationship Between Oral Frailty Index-8 Cutoff Values and Dysphagia in Older Patients With Hip Fracture: A Retrospective Cohort Study 老年髋部骨折患者口腔虚弱指数-8临界值与吞咽困难的关系：一项回顾性队列研究

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

Journal of oral rehabilitation

Pub Date : 2025-10-04 DOI: 10.1111/joor.70072

Yoshihiro Watanabe, Yoichi Sato, Toshiaki Tamura, Ryota Imai, Takafumi Abe, Takayuki Kuwabara, Koki Maruyama, Takao Wakai, Shinya Ibuchi, Hirokazu Ashiga, Masako Fujiu-Kurachi

Background

Early detection of dysphagia, which is frequent in older patients with hip fractures, is challenging. Oral frailty, reflecting age-related decline in oral function, may serve as an early indicator of dysphagia risk.

Objectives

To evaluate whether preoperative oral frailty, assessed by the Oral Frailty Index-8 (OFI-8), is associated with dysphagia and to determine the optimal OFI-8 cutoff for predicting it.

Methods

This single-centre retrospective cohort study included 130 patients ≥ 65 years with hip fractures. Preoperative oral frailty was assessed using OFI-8. Dysphagia at discharge was defined as a Functional Oral Intake Scale score ≤ 5. Logistic regression analysis with Firth's penalised likelihood method was performed to evaluate associations between dysphagia risk and both oral frailty status (present/absent) and OFI-8 scores. Receiver operating characteristic (ROC) analysis was conducted to determine the optimal OFI-8 cutoff.

Results

Dysphagia was observed in 10.0% (13/130) of the patients. None of the patients without oral frailty developed dysphagia, whereas 13.8% of those with oral frailty did (p = 0.019). Higher OFI-8 scores were significantly associated with increased dysphagia risk (odds ratio = 1.81; 95% confidence interval [CI]: 1.27–2.98; p < 0.001). ROC analysis identified an OFI-8 cutoff of 7, with an area under the curve of 0.886, sensitivity 92.3%, and specificity 72.6%. Severe oral frailty (OFI-8 ≥ 7) was strongly associated with dysphagia (odds ratio = 13.35; 95% CI: 2.80–130.87; p < 0.001).

Conclusion

Higher OFI-8 scores and severe oral frailty are independently associated with dysphagia risk.

背景：老年髋部骨折患者中常见的吞咽困难的早期检测具有挑战性。口腔虚弱，反映了与年龄相关的口腔功能下降，可以作为吞咽困难风险的早期指标。目的：通过口腔虚弱指数-8 （OFI-8）评估术前口腔虚弱是否与吞咽困难相关，并确定预测吞咽困难的最佳OFI-8临界值。方法：这项单中心回顾性队列研究纳入了130例≥65岁的髋部骨折患者。术前使用OFI-8评估口腔虚弱。出院时吞咽困难定义为功能性口腔摄入量表评分≤5分。采用Firth惩罚似然法进行Logistic回归分析，评估吞咽困难风险与口腔虚弱状态（存在/不存在）和OFI-8评分之间的关系。采用受试者工作特征（ROC）分析确定最佳OFI-8截止点。结果：10.0%（13/130）患者出现吞咽困难。没有口腔虚弱的患者没有出现吞咽困难，而有口腔虚弱的患者有13.8%出现吞咽困难（p = 0.019）。较高的OFI-8评分与吞咽困难风险增加显著相关（优势比= 1.81；95%可信区间[CI]: 1.27-2.98; p）结论：较高的OFI-8评分和严重的口腔虚弱与吞咽困难风险独立相关。

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引用次数: 0