Predictors of treatment outcome in patients with myofascial pain-dysfunction syndrome and organic temporomandibular joint disorders

Abstract

A total of 46 variables were initially examined for their usefulness as predictors of treatment outcome in patients with facial pain diagnosed as either MPDS or an organic disorder, such as disease of the TMJ (for example, degenerative joint disease or inflammatory arthritis) or typical facial neuralgia. The information about each variable was collected from the patients prior to beginning of treatment. Data included sociocultural background, social group attitudes, sociomedical orientation, level of psychologic distress, symptoms and treatment history, behavioral and attitudinal responses to pain, and clinical findings. Two discriminant analyses were performed to determine the most important variables for predicting whether a patient would respond successfully (with either elimination of or significant decrease in pain) or unsuccessfully (no change or increase in pain) to conservative reversible treatment. The first analysis was used to reduce the original group of 46 variables to 18 variables, which were labelled "potential" predictors. In the first analysis it was noted that clinical factors, such as oral status and physical examination findings, were irrelevant for predicting treatment outcome. Of the 16 clinical variables initially included for analysis, only the presence of clenching was included as a potential predictor. Patients' psychologic status, as measured by their level of psychologic distress, was also not relevant. The greatest number of potential predictors was related to patients' sociocultural background, sociomedical orientation, symptom and treatment history, and behavior in response to and attitudes toward pain. These factors, then, appear to be more useful than clinical and physical data as indicators of the potential response of facial pain patients with either MPDS or organic TMJ deficits to treatment.(ABSTRACT TRUNCATED AT 250 WORDS)