Pain Predictors in a Population of Temporomandibular Disorders Patients

Magdalena Osiewicz,Frank Lobbezoo,Bartosz Ciapała,Jolanta Pytko-Polończyk,Daniele Manfredini

doi:10.3390/jcm9020452

Abstract

The aim of the present study was to assess the potential role of some biological, psychological, and social factors to predict the presence of painful temporomandibular disorders (TMDs) in a TMD-patient population. The study sample consisted of 109 consecutive adult patients (81.7% females; mean age 33.2 ± 14.7 years) who were split into two groups based on Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) diagnoses: painful TMD and non-painful TMD. The presence of pain was adopted as the depended variable to be identified by the following independent variables (i.e., predictors): age, gender, bruxism, tooth wear, chewing gum, nail biting, perceived stress level, chronic pain-related impairment (GCPS), depression (DEP), and somatization (SOM). Single-variable logistic regression analysis showed a significant relationship between TMD pain and DEP with an odds ratio of 2.9. Building up a multiple variable model did not contribute to increase the predictive value of a TMD pain model related to the presence of depression. Findings from the present study supported the existence of a relationship between pain and depression in painful TMD patients. In the future, study designs should be improved by the adoption of the best available assessment approaches for each factor.

Highlights

Temporomandibular disorders (TMDs) are a heterogeneous group of conditions characterized by the presence of signs and symptoms such as pain in the masticatory muscles and/or the temporomandibular joint (TMJ), limited jaw movements, and TMJ sounds during function [1]
A shortcoming of the literature on the topic is that the majority of risk assessment studies on TMDs is based on non-patient populations [15,16], whilst the studies on TMD patient populations are focused on specific subpopulations of TMDs [6,17]
Criteria for inclusion in the study were: 1) the presence of one or multiple TMD diagnoses according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD); 2) the absence of signs and/or symptoms of systemic or local diseases possibly mimicking TMDs, as excluded by relevant consultants; and 3) the absence of other orofacial disorders possibly mimicking TMD-like signs and/or symptoms, as excluded based on the patients’ history and relevant consultants’ reports

Summary

Introduction

Temporomandibular disorders (TMDs) are a heterogeneous group of conditions characterized by the presence of signs and symptoms such as pain in the masticatory muscles and/or the temporomandibular joint (TMJ), limited jaw movements, and TMJ sounds (i.e., clicking and/or crepitus) during function [1]. Amongst the possible biological etiological and risk factors, considerable attention has been given to bruxism, i.e., jaw-muscle activities occurring during sleep (identified as rhythmic or non-rhythmic) and/or wakefulness (characterized by repetitive or sustained tooth contact and/or by bracing or thrusting of the mandible), as well as to various oral habits, such as chewing gum and nail biting [7]. Those activities may cause painful TMDs due to overloading of the musculoskeletal structures, but evidence of a clear-cut association is lacking [8,9]. A shortcoming of the literature on the topic is that the majority of risk assessment studies on TMDs is based on non-patient populations [15,16], whilst the studies on TMD patient populations are focused on specific subpopulations of TMDs (e.g., muscle or joint disorders) [6,17]

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