Journal of oral rehabilitation最新文献_第5页

Clinical and Psychological Profiles of Patients With Subclinical Versus Self-Reported Painful Temporomandibular Disorders 亚临床与自述疼痛颞下颌疾病患者的临床和心理特征。

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

Journal of oral rehabilitation

Pub Date : 2025-12-12 DOI: 10.1111/joor.70136

Thiprawee Chattrattrai, Supawadee Jariyasakulroj, Somsak Mitrirattanakul

Objective

To compare clinical examination findings, functional limitations, and psychological profiles between patients with subclinical temporomandibular disorders (TMD) and those with self-reported painful TMD.

Materials and Methods

This cross-sectional study investigated 98 subclinical TMD patients and 262 self-reported painful TMD patients attending a specialised orofacial pain clinic. Subclinical TMD was defined as positive palpation findings without muscle or joint pain complaints. Self-reported painful TMD required both pain complaints and positive clinical findings. Validated questionnaires assessed jaw functional limitations (JFLS-20), depression (PHQ-9), stress (SPST-20), and oral behaviours (OBC). Statistical analysis used Mann–Whitney U tests and chi-square tests with Bonferroni correction.

Results

Self-reported painful TMD patients were significantly older (median age 39 vs. 31 years, p = 0.003), showed greater jaw functional limitations (JFLS global score: 1.88 vs. 0.75, p < 0.001), and higher depression scores (PHQ-9: 1.0 vs. 0.0, p < 0.001). Sleep bruxism frequency differed significantly between groups (p < 0.001), with subclinical patients more commonly reporting frequent sleep bruxism. No significant differences were found in stress levels, overall oral behaviours, or daytime clenching frequency.

Conclusions

Patients with self-reported painful TMD demonstrate distinct clinical profiles characterised by greater functional impairment and psychological distress compared to subclinical cases.

Clinical Relevance

These findings suggest different phenotypes within the TMD spectrum that may require tailored clinical approaches. Longitudinal studies are needed to determine whether subclinical TMD represents an early stage or a distinct entity.

目的：比较亚临床颞下颌疾病（TMD）患者和自述疼痛性TMD患者的临床检查结果、功能限制和心理特征。材料和方法：本横断面研究调查了98名亚临床TMD患者和262名在专门的口腔面部疼痛诊所就诊的自我报告疼痛的TMD患者。亚临床TMD定义为无肌肉或关节疼痛主诉的阳性触诊结果。自我报告的疼痛性TMD需要疼痛主诉和积极的临床表现。经过验证的问卷评估了下颌功能限制（JFLS-20）、抑郁（PHQ-9）、压力（SPST-20）和口腔行为（OBC）。统计分析采用Mann-Whitney U检验和卡方检验，并进行Bonferroni校正。结果：自我报告的疼痛性TMD患者明显年龄较大（中位年龄39比31岁，p = 0.003），下颌功能受限更严重（JFLS总体评分：1.88比0.75,p）。结论：与亚临床病例相比，自我报告的疼痛性TMD患者表现出明显的临床特征，其功能障碍和心理困扰更大。临床相关性：这些发现表明，TMD谱系中不同的表型可能需要量身定制的临床方法。需要纵向研究来确定亚临床TMD是否代表早期阶段或一个独特的实体。

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引用次数: 0

A Pharmacological and Critical Review of Caffeine and Alpha-Lipoic Acid for Burning Mouth Syndrome 咖啡因和α -硫辛酸治疗灼口综合征的药理学和批判性综述。

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

Journal of oral rehabilitation

Pub Date : 2025-12-12 DOI: 10.1111/joor.70126

Takahiko Nagamine

Clinical trials combining caffeine and 5-ALA for British Meditational Syndrome (BMS) have shown preliminary signs of short-term symptom relief. These substances, which are not traditional painkillers, act through unique, non-traditional mechanisms that are usefully understood through mechanism-based nomenclature.

联合咖啡因和5-ALA治疗英国冥想综合征（BMS）的临床试验显示出短期症状缓解的初步迹象。这些物质不是传统的止痛药，通过独特的非传统机制起作用，通过基于机制的命名法可以有效地理解这些机制。

引用次数: 0

Masticatory Function in Elderly Individuals Living in Long-Term Care Facilities in Brazil: Associations Between Objective and Subjective Measurements 生活在巴西长期护理机构的老年人咀嚼功能：客观和主观测量之间的关联。

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

Journal of oral rehabilitation

Pub Date : 2025-12-11 DOI: 10.1111/joor.70133

Lorena Tavares Gama, Mariana Marinho Davino de Medeiros, Yuri Wanderley Cavalcanti, Mario Augusto Brondani, Renata Cunha Matheus Rodrigues Garcia

Background

Although objective and subjective masticatory function measures may correlate, associated oral health–related factors may differ, highlighting the need for comprehensive assessment to support tailored care in long-term care facilities (LTCFs).

Objective

To investigate the association between objective and subjective masticatory function and the oral health status of older LTCF residents in Brazil.

Materials and Methods

This cross-sectional study included 187 residents (mean age = 78.7 ± 9.2 years) from nine LTCFs. Masticatory function was evaluated objectively (bi-coloured chewing gum) and subjectively (‘Do you have trouble biting or chewing any kind of food?’). Oral health status was assessed by self-perceived oral health, the number of natural teeth and posterior occluding pairs (POPs), xerostomia and dental prosthesis requirement. Data were analysed using multiple regression (α = 0.05).

Results

Objective and subjective masticatory function were associated (p < 0.001). Older age (p = 0.006), low number of natural teeth (p = 0.001) and POPs (p = 0.004) and the dental prosthesis requirement (p = 0.016) were associated with poorer objective masticatory function. Poor self-perceived oral health (p = 0.001), low number of POPs (p = 0.013), severe xerostomia symptoms (p = 0.001) and dental prosthesis requirement (p = 0.030) were associated with poor subjective masticatory function.

Conclusion

Objective and subjective masticatory functions were associated and shared some common factors, number of POPs and the need for dental prostheses. However, objective measures (e.g., number of teeth) were linked to objective masticatory function, whereas self-perceived factors (e.g., perceived oral health and xerostomia) were associated with subjective masticatory function.

背景：虽然客观和主观咀嚼功能测量可能相关，但相关的口腔健康相关因素可能不同，强调需要进行全面评估，以支持长期护理机构（ltcf）的量身定制护理。目的：探讨巴西老年LTCF居民主观、客观咀嚼功能与口腔健康状况的关系。材料和方法：本横断面研究包括来自9个ltcf的187名居民（平均年龄= 78.7±9.2岁）。对咀嚼功能进行客观评估（双色口香糖）和主观评估（“你在咬或咀嚼任何食物时有困难吗？”）。通过自我口腔健康、自然牙和后牙对（pop）数量、口干症和义齿需求来评估口腔健康状况。数据采用多元回归分析（α = 0.05）。结果：客观咀嚼功能与主观咀嚼功能存在相关性(p)。结论：客观咀嚼功能与主观咀嚼功能存在相关性，存在一些共同的因素，如持久性有机污染物（POPs）的数量和修复体的需要量。然而，客观测量（如牙齿数量）与客观咀嚼功能有关，而自我感知因素（如感知口腔健康和口干）与主观咀嚼功能有关。

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引用次数: 0

Modified Relative Handgrip Strength and Tooth Loss: A Nationwide Study 改良的相对握力和牙齿脱落：一项全国性研究。

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

Journal of oral rehabilitation

Pub Date : 2025-12-10 DOI: 10.1111/joor.70135

Yoon-Jin Kim, Ji-Eun Kim, Choong-Ho Choi, Ki-Ho Chung

Background

Handgrip strength (HGS) reflects overall muscular fitness and health. Although associations between absolute or BMI-adjusted HGS and systemic conditions have been studied, no research has examined its link to tooth loss using modified relative HGS indices from other anthropometric factors.

Objectives

This study aimed to investigate, for the first time, the association between tooth loss and various modified relative HGS indices using nationally representative data.

Methods

Using the 2014–2023 Korean National Health and Nutrition Examination Survey data (n = 52 206), relative HGS was calculated by adjusting dominant HGS with various body indices. Oral status was classified as functional (≥ 20 teeth) or reduced (< 20 teeth). Statistical analysis to assess associations and diagnostic accuracy was performed using the chi-square test, t-test, incidence rate ratio (IRR), and the receiver operating characteristic (ROC).

Results

In the fully adjusted IRR analysis, waist circumference (WC)-based relative HGS showed the strongest inverse association with tooth loss (IRR = 0.505, 95% confidence interval [CI] = 0.388–0.656). The ROC analysis revealed that relative HGS indicators adjusted for WC, waist-to-height ratio (WHtR), and weight-adjusted waist index (WWI), which represent central adiposity, had the highest diagnostic accuracy for predicting tooth loss (area under the curve [AUC] = 0.6367, 0.6323, and 0.6316, respectively). Significant differences were observed in all HGS indicators based on the functional dentition criterion (p < 0.001).

Conclusion

WC-adjusted relative HGS showed the strongest inverse association with tooth loss, indicating its potential utility for early identification of high-risk individuals and informing multidisciplinary approaches to oral rehabilitation.

背景：握力（HGS）反映了整体肌肉的健康状况。虽然已经研究了绝对HGS或bmi调整后的HGS与全身状况之间的关系，但没有研究使用其他人体测量因素修正的相对HGS指数来检查其与牙齿脱落的联系。目的：本研究旨在首次利用具有全国代表性的数据，探讨牙齿脱落与各种改良的相对HGS指标之间的关系。方法：利用2014-2023年韩国国民健康与营养检查调查数据（n = 52 206），通过调整优势HGS与各种身体指标，计算相对HGS。结果：在全校正IRR分析中，以腰围（WC）为基础的相对HGS与牙齿脱落呈最强的负相关（IRR = 0.505, 95%可信区间[CI] = 0.388-0.656）。ROC分析显示，代表中心性肥胖的WC、腰高比（WHtR）和体重调整腰围指数（WWI）调整后的相对HGS指标预测牙齿缺失的诊断准确率最高（曲线下面积[AUC]分别= 0.6367、0.6323和0.6316）。基于功能牙列标准的所有HGS指标均存在显著差异(p)。结论：wc调整的相对HGS与牙齿脱落呈最强的负相关，表明其在早期识别高危个体和为口腔康复提供多学科方法方面的潜在效用。

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引用次数: 0

Sleep Bruxism: Mapping Potential Direct and Indirect Risk Pathways in EPISONO Adult Population-Based Study 睡眠磨牙症：在成人人群基础研究中绘制潜在的直接和间接风险通路。

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

Journal of oral rehabilitation

Pub Date : 2025-12-08 DOI: 10.1111/joor.70128

Eduardo Machado, Jessica Klöckner Knorst, Milton Maluly Filho, Monica Levy Andersen, Sergio Tufik, Cibele Dal Fabbro, Dalva Poyares

Aim

To explore the direct and indirect pathways through which sociodemographic, psychological, behavioural, and clinical factors influence sleep bruxism (SB).

Methods

This cross-sectional study was conducted with a sample of 686 adults (mean age of 50.1 years; 380 female and 306 male), from a total of 712 individuals from the Sao Paulo Epidemiological Sleep Study (EPISONO) follow performed in 2015. SB was assessed using self-report, overnight polysomnography (PSG-based), and combined methods. Sociodemographic, psychological, behavioural and clinical factors were assessed. Structural Equation Modelling was used to examine the pathways between potential risk factors and SB.

Results

From an initial sample of 1042, 712 returned for follow-up and 686 individuals were eligible based on the SB outcomes evaluated and having undergone PSG. The SB self-reported prevalence was 17.1%, 30.5% presented PSG-based SB and 7.4% in combination of methods (self-report+PSG). Sleep bruxism (assessed by all methods) was directly associated with higher levels of insomnia and younger age. Higher socioeconomic status was directly associated with self-reported SB, whereas PSG-based and self-report+PSG SB were associated with increased obstructive sleep apnea and smoking. Regarding indirect effects, elevated anxiety and depressive symptoms indirectly impacted all forms of SB via increased insomnia levels.

Conclusions

Our findings highlight distinct and overlapping pathways of SB. Insomnia and younger age consistently predicted SB, while psychological factors indirectly impacted SB via insomnia. Demographic, behavioural, and clinical factors showed direct associations that varied according to the assessment method.

目的：探讨社会人口学、心理、行为和临床因素影响睡眠磨牙症的直接和间接途径。方法：本横断面研究的样本为686名成年人（平均年龄50.1岁，女性380人，男性306人），来自2015年圣保罗流行病学睡眠研究（EPISONO）的712名个体。采用自我报告、夜间多导睡眠图（PSG-based）和综合方法评估SB。对社会人口学、心理、行为和临床因素进行了评估。结构方程模型用于检查潜在危险因素与SB之间的途径。结果：从1042个初始样本中，712人返回随访，686人根据SB结果评估并接受了PSG治疗。自我报告的SB患病率为17.1%，以PSG为基础的患病率为30.5%，联合方法（自我报告+PSG）的患病率为7.4%。睡眠磨牙症（通过所有方法进行评估）与较高程度的失眠症和更年轻直接相关。较高的社会经济地位与自我报告的SB直接相关，而基于PSG和自我报告+PSG SB与阻塞性睡眠呼吸暂停和吸烟增加相关。关于间接影响，焦虑和抑郁症状的升高通过增加失眠水平间接影响所有形式的SB。结论：我们的研究结果强调了SB的不同和重叠的途径。失眠和年轻一致地预测SB，而心理因素通过失眠间接影响SB。根据不同的评估方法，人口统计、行为和临床因素显示出不同的直接关联。

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引用次数: 0

Reconsidering Diagnostic Contexts and Validation Pathways for Dental-Dedicated MRI in Temporomandibular Joint Assessment 重新考虑牙科专用MRI在颞下颌关节评估中的诊断背景和验证途径。

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

Journal of oral rehabilitation

Pub Date : 2025-12-08 DOI: 10.1111/joor.70134

Carlos M. Ardila

引用次数: 0

Temporomandibular Disorder Pain and Somatic Symptoms in Migraine Patients: Idioms of Psychological Distress and Impact on Quality of Life 偏头痛患者的颞下颌紊乱、疼痛和躯体症状：心理困扰习语及其对生活质量的影响。

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

Journal of oral rehabilitation

Pub Date : 2025-12-08 DOI: 10.1111/joor.70127

Adrian Ujin Yap, Wei Yang Wong, Wai Kin Yuen, Huann Lan Tan, Wan Nur Nafisah Wan Yahya, Rifqah Nordin

Background

Studies on painful temporomandibular disorders (TMDs) and somatic symptoms in Southeast Asian migraine patients are lacking.

Objectives

This study investigated the prevalence of TMD pain and somatic symptoms in migraine patients, examining their relationships with pain characteristics, psychological distress, and quality of life (QOL). Additionally, it identified factors associated with moderate-to-severe distress, low QOL, and poor general health.

Methods

Participants were recruited from a neurology clinic, where migraines were diagnosed based on the ICHD-3 criteria. A trained interviewer administered a questionnaire comprising sociodemographics, migraine-specific information, the DC/TMD TMD pain screener (TPS), Graded Chronic Pain Scale (GCPS), Patient Health Questionnaires (PHQ-15/PHQ-4), and WHOQOL-BREF. Data were analysed employing Chi-square/Mann–Whitney U tests, Spearman's correlation, and logistic regression analysis (α = 0.05).

Results

Among the 106 participants (mean age 45.3 years [SD = 14.0]), 31.1% experienced TMD pain, while 37.7% exhibited medium-to-high somatic symptoms. Individuals with comorbid migraine-TMD pain had a higher somatic symptom burden, distress, and poorer psychological/environmental QOL. Those with medium-to-high somatic symptoms reported more frequent migraines, greater pain intensity/disability, higher TMD pain propensity, elevated distress, and worse QOL in all domains. Somatic symptoms, but not TMD pain, were negatively and moderately correlated with general health, physical, and psychological QOL (rs = −0.41 to −0.53). Somatic symptoms (OR 1.34) and poor general health (OR 3.06) increased the odds of moderate-to-severe distress and low overall QOL, respectively.

Conclusions

To effectively manage migraine patients, screening for TMDs and addressing somatic symptoms and general health are essential for reducing psychological distress and enhancing overall QOL.

背景：目前对东南亚偏头痛患者疼痛性颞下颌紊乱（TMDs）和躯体症状的研究尚缺乏。目的：本研究调查偏头痛患者TMD疼痛和躯体症状的患病率，探讨其与疼痛特征、心理困扰和生活质量（QOL）的关系。此外，它还确定了与中度至重度痛苦、低生活质量和一般健康状况不佳相关的因素。方法：参与者从神经病学诊所招募，根据ICHD-3标准诊断偏头痛。一名训练有素的采访者对患者进行问卷调查，包括社会人口统计学、偏头痛特异性信息、DC/TMD TMD疼痛筛查（TPS）、慢性疼痛分级量表（GCPS）、患者健康问卷（PHQ-15/PHQ-4）和WHOQOL-BREF。资料分析采用χ 2 /Mann-Whitney U检验、Spearman相关和logistic回归分析（α = 0.05）。结果：106名参与者（平均年龄45.3岁[SD = 14.0]）中，31.1%经历过TMD疼痛，37.7%表现出中重度躯体症状。患有偏头痛- tmd合并症的个体有较高的躯体症状负担、窘迫和较差的心理/环境生活质量。有中重度躯体症状的患者报告偏头痛更频繁，疼痛强度/残疾更大，TMD疼痛倾向更高，痛苦加剧，所有领域的生活质量更差。躯体症状，而不是TMD疼痛，与总体健康、身体和心理生活质量呈负相关和中度相关（rs = -0.41至-0.53）。躯体症状（OR 1.34）和一般健康状况不佳（OR 3.06）分别增加了中度至重度痛苦和低总体生活质量的几率。结论：为了有效管理偏头痛患者，筛查tmd，解决躯体症状和一般健康问题对于减少心理困扰和提高总体生活质量至关重要。

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引用次数: 0

Reliability of Lingual Swallow Pressure Measurements in Healthy Older and Younger Adults 健康老年人和年轻人舌吞压力测量的可靠性。

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

Journal of oral rehabilitation

Pub Date : 2025-12-03 DOI: 10.1111/joor.70125

Julian Bergen Smith, Kelsey Murray, Sarah H. Szynkiewicz, Peter A. Wasiuk, Meghan Dalton, Kirsty Thompson, Erin Kamarunas

Background

While maximum isometric pressure (MIP) is widely used in clinical and research settings, reduced lingual swallow pressure (LSP) has been observed in patients with dysphagia and in older healthy adults. However, limited evidence exists on the test–retest reliability of LSP across different bolus consistencies.

Objective

This study assessed the test–retest reliability of LSP measurements in both younger and older adults with healthy swallowing function to identify factors influencing oral swallowing pressure.

Methods

Participants 18–40 years (younger) and 60+ years (older) were assessed across four separate sessions. Bolus types included trials of saliva, thin, mildly thick and extremely thick water, randomised across study visits. Two-way mixed effects models with absolute agreement were used to calculate intraclass correlation coefficients (ICCs) and evaluate test–retest reliability of LSP for each swallow type (regular or effortful) and bolus type. Linear mixed effects regression modelling was used to examine the factors influencing LSP.

Results

A total of 51 participants were included. Test–retest reliability for LSP ranged from good to excellent across both groups (ICC = 0.79–0.98). Reliability was non-significantly higher in the older group (ICC = 0.96) and during effortful swallows (ICC = 0.94). Effort level significantly influenced LSP estimates, with effortful swallows producing about 1.83 times more lingual pressure than regular swallows. There were no significant effects of age, sex, or bolus type on LSP.

Conclusion

These findings suggest that LSP measurements are reliable across measurement time points in nondysphagic participants, regardless of age, effort level, or bolus type. Only swallow effort level significantly influenced LSP estimates.

背景：虽然最大等长压力（MIP）在临床和研究中被广泛使用，但在吞咽困难患者和健康老年人中也观察到舌吞压力（LSP）的降低。然而，LSP跨不同一致性的重测信度研究证据有限。目的：本研究对吞咽功能正常的年轻人和老年人进行LSP测量的重测信度评估，以确定影响口腔吞咽压力的因素。方法：对18-40岁（年轻）和60岁以上（年长）的参与者进行四个单独的评估。药丸类型包括唾液试验、稀水、轻度浓水和极浓水，在研究访问中随机分配。采用绝对一致的双向混合效应模型计算类内相关系数（ICCs），并评估LSP对每一种吞咽类型（常规或费力）和丸剂类型的重测信度。采用线性混合效应回归模型研究影响LSP的因素。结果：共纳入51例受试者。两组LSP的重测信度从良好到优秀不等（ICC = 0.79-0.98）。可靠性在老年组（ICC = 0.96）和努力吞咽组（ICC = 0.94）中无显著性提高。努力程度显著影响LSP估计，努力吞咽产生的舌压是正常吞咽产生舌压的1.83倍。年龄、性别、药物类型对LSP无显著影响。结论：这些发现表明LSP测量在非吞咽困难参与者的测量时间点上是可靠的，无论年龄，努力水平或丸类型。只有吞咽努力程度显著影响LSP估计。

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引用次数: 0

The Relationship Between Oral Pain and Dietary Inflammatory Potential 口腔疼痛与饮食炎症电位的关系。

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

Journal of oral rehabilitation

Pub Date : 2025-11-28 DOI: 10.1111/joor.70121

Wanyu Wang, Qiang Luo, Jie Lin, Yue Li, Yang Ji

Background

Chronic orofacial pain is a prevalent health issue with multifactorial aetiology, including potential contributions from diet-related inflammation. This study aimed to investigate the association between dietary inflammatory potential, assessed using the Dietary Inflammatory Index (DII), and self-reported oral pain among US adults.

Methods

We conducted a cross-sectional analysis using data from 23 802 participants in the National Health and Nutrition Examination Survey (NHANES) 2005–2018 who completed dietary recalls and responded to oral health questions. Oral pain was assessed by the frequency of self-reported aching in the mouth over the past year (NHANES variable OHQ620). Logistic regression models were used to assess the association between DII scores and oral pain. Subgroup analyses were conducted to identify populations most affected by a pro-inflammatory diet.

Results

Higher DII scores were significantly associated with an increased likelihood of experiencing oral pain. Participants in the highest DII quintile (27.19%) had a 19% higher risk of oral pain compared with those in the lowest quintile (20.69%), even after full adjustment (OR = 1.19, 95% CI: 1.03–1.37, p = 0.016). The association was particularly pronounced in younger individuals, females, non-Hispanic Whites, those with higher socio-economic status, normal BMI, a history of smoking, and relatively low alcohol consumption.

Conclusion

These findings suggest that pro-inflammatory dietary patterns may exacerbate oral pain, potentially mediated through systemic inflammation or local mucosal irritation. While based on self-reported oral pain, the study highlights diet modification as a preventive strategy and calls for further research on specific pain subtypes.

背景：慢性口面部疼痛是一种多因素的普遍健康问题，包括与饮食相关的炎症的潜在贡献。本研究旨在调查饮食炎症潜能（通过饮食炎症指数（DII）评估）与美国成年人自我报告的口腔疼痛之间的关系。方法：我们对2005-2018年国家健康与营养检查调查（NHANES）中23802名参与者的数据进行了横断面分析，这些参与者完成了饮食召回并回答了口腔健康问题。口腔疼痛通过过去一年中自我报告口腔疼痛的频率来评估（NHANES变量OHQ620）。采用Logistic回归模型评估DII评分与口腔疼痛之间的关系。进行亚组分析以确定受促炎饮食影响最大的人群。结果：较高的DII评分与经历口腔疼痛的可能性增加显著相关。即使在完全调整后，DII最高五分位数的参与者（27.19%）与最低五分位数的参与者（20.69%）相比，口腔疼痛的风险高出19% （OR = 1.19, 95% CI: 1.03-1.37, p = 0.016）。这种关联在年轻人、女性、非西班牙裔白人、社会经济地位较高、BMI正常、有吸烟史和相对较低饮酒量的人群中尤为明显。结论：这些研究结果表明，促炎饮食模式可能会加剧口腔疼痛，可能通过全身炎症或局部粘膜刺激介导。虽然基于自我报告的口腔疼痛，但该研究强调了饮食调整作为一种预防策略，并呼吁对特定疼痛亚型进行进一步研究。

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引用次数: 0

Predictive Value of Diagnostic Methods for TMJ Hypermobility in the Associated Clinical and Functional Features of Temporomandibular Disorders: A Regression Study 颞下颌关节过度活动的诊断方法对颞下颌疾病相关临床和功能特征的预测价值：一项回归研究。

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

Journal of oral rehabilitation

Pub Date : 2025-11-27 DOI: 10.1111/joor.70120

Samilla Pontes Braga, Dyanne Medina Flores, Maria Emilia Servin Berden, Ana Claudia de Castro Ferreira Conti, Ambrosina Michelotti, Paulo César Rodrigues Conti

Background

Joint hypermobility (JH), particularly at the temporomandibular joint (TMJ), has been proposed as a potential risk factor for temporomandibular disorders (TMD). However, its heterogeneous diagnostic approaches (clinical, anamnestic and imaging) limit the identification of reliable predictors of masticatory dysfunction and TMD outcomes.

Objectives

To determine which diagnostic methods for TMJ hypermobility best predict masticatory dysfunction and the clinical and functional repercussions of TMD.

Methods

This cross-sectional study included 126 adults recruited at the Bauru School of Dentistry. Participants were classified by Diagnostic Criteria for TMD (DC/TMD) into painful, dysfunction or combined groups, balanced by history of open-locking. Assessments comprised DC/TMD and ICOP examinations, symptom intensity on the visual analog scale (VAS), Beighton score, pressure pain thresholds, bite-force and fatigue tests, ultrasound of the TMJ capsule and masseter, CBCT-based condylar angle and validated measures of mandibular function and psychosocial factors.

Results

Bivariate analyses yielded associations, but multivariate models identified specific predictors. Open-locking independently predicted TMJ subluxation and higher joint instability. Increased condylar angle was associated with greater assisted opening and midline deviation. Unassisted opening predicted a larger condylar angle, greater pain-free opening and lateral condylar jump; assisted opening similarly predicted pain-free opening and lateral condylar jump. Lateral condylar jump independently predicted functional limitation in wide-opening tasks.

Conclusion

Clinical, functional and imaging indicators of TMJ hypermobility capture distinct aspects of the condition. While open-locking, condylar angle and mouth-opening measures predict specific features, no single marker explains the full spectrum and TMJ hypermobility shows limited impact on overall TMD outcomes.

背景：关节活动过度（JH），特别是在颞下颌关节（TMJ），已被认为是颞下颌疾病（TMD）的潜在危险因素。然而，其不同的诊断方法（临床、记忆和影像学）限制了对咀嚼功能障碍和TMD结果的可靠预测。目的：探讨颞下颌关节运动亢进的诊断方法，以更好地预测咀嚼功能障碍及其临床和功能影响。方法：这项横断面研究包括从Bauru牙科学院招募的126名成年人。根据TMD诊断标准（DC/TMD）将参与者分为疼痛组、功能障碍组或合并组，并根据开锁病史进行平衡。评估包括DC/TMD和ICOP检查、视觉模拟量表（VAS）的症状强度、Beighton评分、压痛阈值、咬力和疲劳测试、TMJ囊和咬肌的超声检查、基于cbct的髁角以及下颌功能和社会心理因素的有效测量。结果：双变量分析得出了相关性，但多变量模型确定了特定的预测因子。开锁独立预测TMJ半脱位和更高的关节不稳定性。增加的髁角与更大的辅助开口和中线偏差有关。无辅助开放预示着更大的髁角，更大的无痛开放和外侧髁跳跃；辅助开放同样预测无痛开放和外侧髁跳。外侧髁跳独立预测大开口任务的功能限制。结论：颞下颌关节过动症的临床、功能和影像学指标反映了该疾病的不同方面。虽然开锁、髁突角度和开口测量可以预测特定的特征，但没有单一的标记可以解释全谱，TMJ过度活动对整体TMD结果的影响有限。

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