颞下颌关节疾病(TMDs)的体征和症状与原发性头痛的关系

Zena Kamel Kadhem, M. Fawzi, Sabah Farhan
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摘要

本研究的目的是探讨疼痛性TMD与原发性头痛(偏头痛和紧张性头痛)的并发体征和症状的关系,以及咀嚼系统的压痛和刺激是否导致头痛。方法与材料:采用研究诊断标准(RDC)诊断为颞下颌关节紊乱(TMD)的患者120例。样本年龄在18-50岁之间。所有患者均完成研究诊断标准RDC\TMD,并应用TMD指数问卷测量TMD的严重程度。然后对所有患者进行临床检查(咀嚼肌检查、关节触诊及偏离、咔嗒声及开口受限)。原发性头痛的评估采用一份经过验证的结构化问卷,收集了区分头痛特征的信息,并与国际头痛疾病分类- ii相似。结果:女性tmd患病率高,头痛患病率高于男性。偏头痛和紧张型头痛患者的咀嚼肌疼痛、关节疼痛、开口受限、咔嗒声和磨牙以及头痛的强度和持续时间,与其他无头痛患者或tmd头痛患者相比,均增加到相关且有统计学意义的程度。结论:TMD在女性中高发,女性也占头痛患者的多数。原发性头痛患者的临床疼痛特征和咀嚼肌压痛更大。
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The Relationship between Signs and Symptoms of Tempromandibular Joint Disorders (TMDs) and Primary Headache
The aims of this study are to investigate the relationship of the concurrent signs and symptoms of a painful TMD with primary headache (migraine and tension type headache) and whether tenderness and provocation of the masticatory system resulted in the headache. Methods and materials : The sample consists of 120 patients which were diagnosed as having temporomandibular joint disorder (TMD) included Research Diagnostic Criteria (RDC). The sample age range was between (18-50 years) . All patients oriented to com- plete the Research Diagnostic Criteria RDC\TMD .The questionnaire for TMD index was also applied to all patients to measure the severity of TMD . Then all patients were subjected to clinical examination (examination of masticatory muscles, joint palpation and deviation, clicking and limitation in mouth opening). Primary Headaches were assessed using a validated structured questionnaire captured information on distinguishing headache features and parallels the International Classification for Headache Disorders-II. Results : females were shown high prevalence of TMDs and headache more than male. The presence of the masticatory muscles pain, joint pain, limitation in mouth opening, clicking and bruxism as well as headache pain intensity and duration, increased to a relevant and statistically significant degree in both migraine and tension type headache patients in compare to other patients had no headache or patients with headache from TMDs. Conclusions: High prevalence of TMD in females and also females represent a majority of headache patients. Clinical pain charac- teristics and masticatory muscle tenderness of TMD are greater in patients with primary headache.
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