Abstract
BackgroundTemporomandibular disorder (TMD) patients might present a number of concurrent clinical diagnoses that may be clustered according to their similarity. Profiling patients’ clinical presentations can be useful for better understanding the behavior of TMD and for providing appropriate treatment planning. The aim of this study was to simultaneously classify symptomatic patients diagnosed with a variety of subtypes of TMD into homogenous groups based on their clinical presentation and occurrence of comorbidities.MethodsClinical records of 357 consecutive TMD patients seeking treatment in a private specialized clinic were included in the study sample. Patients presenting multiple subtypes of TMD diagnosed simultaneously were categorized according to the AAOP criteria. Descriptive statistics and two-step cluster analysis were used to characterize the clinical presentation of these patients based on the primary and secondary clinical diagnoses.ResultsThe most common diagnoses were localized masticatory muscle pain (n = 125) and disc displacement without reduction (n = 104). Comorbidity was identified in 288 patients. The automatic selection of an optimal number of clusters included 100% of cases, generating an initial 6-cluster solution and a final 4-cluster solution. The interpretation of within-group ranking of the importance of variables in the clustering solutions resulted in the following characterization of clusters: chronic facial pain (n = 36), acute muscle pain (n = 125), acute articular pain (n = 75) and chronic articular impairment (n = 121).ConclusionSubgroups of acute and chronic TMD patients seeking treatment can be identified using clustering methods to provide a better understanding of the clinical presentation of TMD when multiple diagnosis are present. Classifying patients into identifiable symptomatic profiles would help clinicians to estimate how common a disorder is within a population of TMD patients and understand the probability of certain pattern of clinical complaints.
Highlights
Temporomandibular disorder (TMD) patients might present a number of concurrent clinical diagnoses that may be clustered according to their similarity
The aim of this study was to classify the symptom presentation of patients who sought treatment and who were diagnosed with a variety of combined subtypes of TMD and to cluster them into homogenous groups based on their clinical condition and chief complaints
The results of this study present different symptomatic profiles of patients seeking treatment in a TMD clinic, who were classified by cluster analysis into four to six homogenous groups based on their clinical presentation
Summary
Temporomandibular disorder (TMD) patients might present a number of concurrent clinical diagnoses that may be clustered according to their similarity. The aim of this study was to simultaneously classify symptomatic patients diagnosed with a variety of subtypes of TMD into homogenous groups based on their clinical presentation and occurrence of comorbidities. It is clear from clinical practice that TMD and orofacial pain patients share many common clinical features or symptoms. The classification of groups of patients who share properties in common might provide useful information for the diagnosis and initial management of TMD. The aim of this study was to classify the symptom presentation of patients who sought treatment and who were diagnosed with a variety of combined subtypes of TMD and to cluster them into homogenous groups based on their clinical condition and chief complaints
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