Clinical Orofacial Characteristics Associated With Risk of First-Onset TMD: The OPPERA Prospective Cohort Study

被引:144
作者
Ohrbach, Richard [1 ]
Bair, Eric [2 ,3 ,4 ]
Fillingim, Roger B. [8 ,9 ]
Gonzalez, Yoly [1 ]
Gordon, Sharon M. [10 ,12 ]
Lim, Pei-Feng [2 ]
Ribeiro-Dasilva, Margarete [13 ]
Diatchenko, Luda [2 ,3 ,14 ,15 ,16 ]
Dubner, Ronald [10 ,11 ,12 ]
Greenspan, Joel D. [10 ,11 ,12 ]
Knott, Charles [17 ]
Maixner, William [2 ,3 ,5 ]
Smith, Shad B. [2 ,3 ]
Slade, Gary D. [2 ,6 ,7 ]
机构
[1] SUNY Buffalo, Dept Oral Diagnost Sci, Buffalo, NY 14214 USA
[2] Univ N Carolina, Reg Ctr Neurosensory Disorders, Chapel Hill, NC USA
[3] Univ N Carolina, Dept Endodont, Chapel Hill, NC USA
[4] Univ N Carolina, Dept Biostat, Chapel Hill, NC USA
[5] Univ N Carolina, Dept Pharmacol, Chapel Hill, NC USA
[6] Univ N Carolina, Dept Dent Ecol, Chapel Hill, NC USA
[7] Univ N Carolina, Dept Epidemiol, Chapel Hill, NC USA
[8] Univ Florida, Coll Dent, Dept Community Dent & Behav Sci, Gainesville, FL USA
[9] Pain Res & Intervent Ctr Excellence, Gainesville, FL USA
[10] Univ Maryland, Sch Dent, Dept Oral & Maxillofacial Surg, Baltimore, MD 21201 USA
[11] Univ Maryland, Sch Dent, Dept Neural & Pain Sci, Baltimore, MD 21201 USA
[12] Univ Maryland, Sch Dent, Brotman Facial Pain Ctr, Baltimore, MD 21201 USA
[13] Univ Florida, Coll Dent, Div Prosthodont, Dept Restorat Dent Sci, Gainesville, FL USA
[14] Univ N Carolina, Carolina Ctr Genome Sci, Chapel Hill, NC USA
[15] McGill Univ, Dept Anesthesia, Montreal, PQ, Canada
[16] McGill Univ, Alan Edwards Ctr Res Pain, Montreal, PQ, Canada
[17] Battelle Mem Inst, Durham, NC USA
基金
美国国家卫生研究院;
关键词
Temporomandibular disorder; cohort studies; trauma; para function; pain; TEMPOROMANDIBULAR DISORDERS; PARAFUNCTIONAL HABITS; ELECTRICAL-ACTIVITY; ORAL PARAFUNCTIONS; PAIN SYMPTOMS; FOLLOW-UP; BEHAVIORS; VALIDITY; RELIABILITY; SIGNS;
D O I
10.1016/j.jpain.2013.07.018
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Case-control studies have documented clinical manifestations of chronic temporomandibular disorder (TMD), whereas clinical predictors of TMD development are largely unknown. We evaluated 41 clinical orofacial characteristics thought to predict first-onset TMD in a prospective cohort study of U.S. adults aged 18 to 44 years. During the median 2.8-year follow-up period, 2,737 people completed quarterly screening questionnaires. Those reporting symptoms were examined and 260 people were identified with first-onset TMD. Univariate and multivariable Cox regression models quantified associations between baseline clinical orofacial measures and TMD incidence. Significant predictors from baseline self-report instruments included oral parafunctions, prior facial pain and its life-impact, temporomandibular joint noises and jaw locking, and nonspecific orofacial symptoms. Significant predictors from the baseline clinical examination were pain on jaw opening and pain from palpation of masticatory, neck, and body muscles. Examiner assessments of temporomandibular joint noise and tooth wear facets did not predict incidence. In multivariable analysis, nonspecific orofacial symptoms, pain from jaw opening, and oral parafunctions predicted TMD incidence. The results indicate that only a few orofacial examination findings influenced TMD incidence, and only to a modest degree. More pronounced influences were found for self-reported symptoms, particularly those that appeared to reflect alterations to systems beyond the masticatory tissues. (C) 2013 by the American Pain Society
引用
收藏
页码:T33 / T50
页数:18
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