Temporomandibular düzensizlik tanı kriterlerini kullanarak temporomandibular bozukluğu olan hastaların klinik değerlendirilmesi ve sınıflandırılması

Year 2020, Volume: 37 Issue: 1, 1 - 6, 01.01.2020

Cansu Alpaslan , Deniz Yaman

https://doi.org/10.17214/gaziaot.567544

Cited By: 5

Abstract

Amaç: Bu çalışmanın amacı, ‘temporomandibular düzensizlikler
için teşhis kriterlerini (DC-TMD)’ kullanarak, temporomandibular düzensizlik
şikâyeti olan hastalarda klinikte alt grupların dağılım sıklığını
değerlendirmektir.

Gereç ve Yöntem: Çalışmaya,
temporomandibular düzensizlik (TMD) şikâyeti olan 128 hasta (92 kadın ve 36 erkek,
yaş ortalaması 33.5 ± 8.28) dahil edildi. DC/TMD Eksen I tanı kriterleri ile
ağrı bozuklukları ve temporomandibular eklem (TME) düzensizliklerinin dağılımı
incelendi. DC/TMD Eksen I’de yer alan TMD Ağrı anketi (TMD Pain Screener) ile de son 30 gün boyunca
mevcut ağrının incelemesi yapılmıştır. Semptomların şiddetini ve fonksiyon
kısıtlılığını belirlemek için DC/TMD Eksen II değerlendirme araçlarından biri
olan ‘Çene Fonksiyon Kısıtlanma Skalası-8 (JFLS-8)’tercih edilmiştir. Verilerin
analizi Ki-kare, Kruskal Wallis testi ve Bonferroni düzeltmeli Mann-Whitney U
testi kullanılarak yapılmıştır.

Bulgular: Çalışmada 128 hastanın 120’sinde (%93.75) kas ağrı
bozukluğuna eşlik eden TME düzensizliği vardı. Cinsiyet ve yaşın, TME/kas ağrı
bozuklukları üzerine etkisi anlamlı değildir (sırasıyla, TME düzensizliği
p=0.123, p=0.263; kas ağrı bozukluğu p=0.145, p=0.100). JFLS-8’e göre, diğer
gruplarla karşılaştırıldığında ‘kısıtlı ağız açıklığı olan redüksiyonsuz disk
deplasmanı’ grubunda, çiğnemede zorluk (1 ve 2. maddeler) ve eklem hareketinde
kısıtlılık (4. madde) majör şikayetler olarak bulunmuştur (p=0.001, p=0.004, p=0.007, p<0.008).

Sonuç: DC/TMD Eksen I, TMD tanısı ve değerlendirilmesinde
klinisyenler için önemli bir referans olup, DC/TMD Eksen II’de JFLS-8, TMD’ye
bağlı çene fonksiyon kısıtlılığın tespitinde etkin bir değerlendirme aracıdır.

Keywords

Temporomandibular eklem bozuklukları, temporomandibular eklem disfonksiyon sendromu, temporomandibular eklem disk

Clinical evaluation and classification of patients with temporomandibular disorders using ‘Diagnostic Criteria for Temporomandibular Disorders’

Abstract

Objective: The aim of the study was to
evaluate the frequency of subgroups in a clinical setting of the patients with
temporomandibular disorders (TMD) using ‘Diagnostic Criteria for
Temporomandibular Disorders (DC/TMD)’.

Materials and Method: A total of 128 patients with TMD (92 females and 36 males, mean age 33.5
± 8.28) were involved in the study. DC/TMD Axis I diagnosis criteria was used
for the clinical examination of pain disorders and temporomandibular joint
(TMJ) disorders. Also, in DC/TMD Axis I, The TMD Pain Screener, focusing on
pain within the last 30 days, was used. In DC/TMD Axis II evaluation, the Jaw
Functional Limitation Scale-8 (JFLS-8) was preferred to detect symptom severity
and functional limitations. The data analysis was conducted by using the
Chi-square, Kruskal Wallis test, and the Bonferroni correction for the
Mann-Whitney U test.

Results: Out
of 128 patients, 120 patients (93.75%) had TMJ disorders that were accompanied
by muscle pain disorders. The effect of gender and age on TMJ/muscle pain
disorders was not significant (TMJ disorders; p=0.123, p=0.263; Muscle pain
disorders; p=0.145, p=0.100, respectively). According to JFLS-8, the limitation
in mastication (item 1 and 2) and joint mobility (item 4) were major complaints
in the group of patients with ‘disc displacement without reduction with limited
opening’ compared to the other TMJ disorders (p=0.001, p=0.004, p=0.007,
p<0.008).

Conclusion: DC/TMD Axis I is a significant reference to clinicians in the diagnosis
and evaluation of TMD. In DC/TMD Axis II, JFLS-8 is an efficient instrument for
the measurement of functional limitation associated with temporomandibular
disorders.

Keywords

Temporomandibular joint disc, temporomandibular joint disorders, temporomandibular joint dysfunction syndrome

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