Cervical Muscle Tenderness in Temporomandibular Disorders and Its Associations with Diagnosis, Disease-Related Outcomes, and Comorbid Pain Conditions
| Autor: | Avraham Zini, Yaron Haviv, Stav Bekker, Boaz Shay, Avraham Zakuto, Galit Almoznino, Hulio Zlutzky, Yair Sharav, Rafael Benoliel |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis Research Diagnostic Criteria Physical examination 02 engineering and technology Palpation Facial Pain Internal medicine 0202 electrical engineering electronic engineering information engineering Whiplash medicine Humans Dentistry (miscellaneous) medicine.diagnostic_test business.industry Headache Myalgia Temporomandibular Joint Disorders 021001 nanoscience & nanotechnology medicine.disease nervous system diseases Masticatory force Tenderness stomatognathic diseases Anesthesiology and Pain Medicine Case-Control Studies Masticatory Muscles Female 020201 artificial intelligence & image processing Neurology (clinical) Headaches medicine.symptom 0210 nano-technology business human activities |
| Zdroj: | Journal of Oral & Facial Pain and Headache. 34:67-76 |
| ISSN: | 2333-0384 |
| DOI: | 10.11607/ofph.2374 |
| Popis: | AIMS To analyze cervical tenderness scores (CTS) in patients with various temporomandibular disorders (TMD) and in controls and to examine associations of CTS with demographic and clinical parameters. METHODS This case-control study included 192 TMD patients and 99 controls diagnosed based on a questionnaire and a clinical examination following the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) guidelines. CTS, adapted from the widely used total tenderness score, was the mean sum of the palpation scores from the suboccipital, sternocleidomastoid, and trapezius muscles. Depending on the variables, data were analyzed using Pearson chi-square, analysis of variance, t test, Bonferroni post hoc adjustment, and/or multivariate linear regression analyses. RESULTS CTS was higher in TMD compared to controls (P < .001). Across TMD subgroups, CTS was notable only in those with a myogenous TMD diagnosis, but not in arthrogenous TMD (P = .014). CTS was positively associated with: female sex (P = .03), whiplash history, higher verbal pain scores, comorbid headaches, body pain, increased pain on mouth opening, and higher masticatory muscles tenderness scores (MTS) (P < .001 for all). Sex (P < .001), MTS (P < .001), comorbid headache (P = .042), and pain on opening (mild: P = .031; moderate: P = .022) retained significant associations with CTS in the multivariate analysis, and these main effects were influenced by interactions with whiplash history and comorbid body pain. CONCLUSION CTS differentiated between TMD patients and controls and between TMD diagnoses. Specific patient and pain characteristics associated with poor outcome in terms of CTS included effects of interactions between myogenous TMD, female sex, whiplash history, comorbid body pain and headaches, and pain on opening. It can therefore be concluded that routine clinical examination of TMD patients should include assessment of the cervical region. |
| Databáze: | OpenAIRE |
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