Temporomandibular Eklem Rahatsızlıklarına Etki Eden Faktörlerin Araştırılması: Kırıkkale Üniversitesi Diş Hekimliği Fakültesi Öğrencileri Örneklemi

Yıl 2024, Cilt: 4 Sayı: 2, 734 - 749, 27.08.2024

Ismayil Malıkov , Sevgi Yurt Öncel , Türkan Sezen Erhamza

Öz

Amaç: Bu çalışmada, Kırıkkale Üniversitesi Diş Hekimliği Fakültesi öğrencileri arasında temporomandibular eklem rahatsızlıklarına (TMDs) etki eden faktörler doğrulayıcı faktör analizi ile araştırılmıştır. Fonseca Anamnestik (FAI) anketi kullanılarak veriler elde edilmiştir. Gereç ve Yöntem: FAI ölçeği ve faktör yapısı öncelikle yamaç grafiği, Kaiser-Meyer-Olkin istatistikleri, Bartlett Küresellik Testi, Cronbach's Alpha ve Guttman's Lamda6 katsayıları kullanılarak analiz edildi. Daha sonra önerilen faktör yapısını doğrulamak için doğrulayıcı faktör analizi yapılmıştır. Bulgular: Tüm ölçek maddelerin FAI üzerinde anlamlı bir etkiye sahip olduğu görülmektedir (p<0,01). FAI ölçeğinin "F1-Fonksiyon-Eşlik Eden Hastalık" alt faktöründe yer alan ve en büyük etkiye sahip olan madde, ağzı geniş açmakta zorlanma ile ilgili olan Madde I1'dir. Gizli faktör tarafından açıklanan varyans %77,9'dur. Bu F1 alt faktörü üzerinde ikinci en yüksek etkiye sahip değişken, kulak ağrısı veya çene ağrısının olup olmadığı hakkında olan Madde I6'dır. Gizil faktör tarafından açıklanan varyansı %65,9'dur. Ayrıca "F2-Oklüzyon-parafonksiyon-psikoloji "alt faktöründe en yüksek etkiye sahip değişken dişleri sıkma veya gıcırdatma alışkanlığı hakkında olan Madde I8’dir. Gizil faktör tarafından açıklanan varyansı %45,6’dır. Sonuç: Elde edilen sonuçlara göre FAI ölçeğinin ölçeğin güvenirlik ve tutarlılığı sağlanmıştır. Tüm uyum kriterleri göz önünde bulundurulduğunda, önerilen modelin örneklem için geçerli olduğu ortaya çıkmıştır. Doğrulayıcı faktör analizi sonuçları, RMSEA, SRMR, GFI, AGFI, CFI, NFI, NNFI, TLI, CR ve AVE indeksleri ile kanıtlandığı üzere, verilerin önerilen modele iyi bir uyum sağladığını göstermiştir. Farklı fizyoterapi tekniklerinin uygulanmasının hastalarda TMD'nin yol açtığı problemleri indirgeyebileceği, ağzı geniş açmakta kolaylık sağlayabileceği, diş sıkma ve çene ağrısını kontrol etmede etkili olabileceği düşünülmektedir.

Anahtar Kelimeler

Açıklayıcı Faktör analizi, Doğrulayıcı faktör analizi, Diş hekimliği öğrencileri, Fonseca Anamnestik (FAI) anketi, Temporomandibular eklem bozuklukları.

Etik Beyan

KIRIKKALE ÜNİVERSİTESİ GİRİŞİMSEL OLMAYAN ARAŞTIRMALAR ETİK KURUL KARARI ALINMIŞTIR Toplantı Tarihi: 25/10/2023 , Toplantı Sayısı: 2023/10, Karar No: 2023.10.15

Investigation of Factors Affecting Temporomandibular Joint Disorders: Sampling of The Faculty of Dentistry of Kırıkkale University

Öz

Objective: In this study, factors affecting temporomandibular joint disorders (TMDs) among Kırıkkale University Faculty of Dentistry students were investigated by confirmatory factor analysis. Data were obtained using the Fonseca Anamnestic Index (FAI). Methods: The FAI scale and its factor structure were first analysed using the scree plot, Kaiser-Meyer-Olkin statistics, Bartlett's Test of Sphericity, Cronbach's Alpha and Guttman's Lamda6 coefficients. Subsequently, confirmatory factor analysis was conducted to verify the proposed factor structure. Results: All scale items appear to have a significant effect on FAI (p<0.01). The item in the "F1-Function-comorbidity" sub-factor of the FAI scale that has the greatest impact is Item I1, which is related to difficulty in opening the mouth wide. The variance explained by the latent factor is 77.9%. The variable with the second highest impact on this F1 factor was Item I6, which was about whether earache or jaw pain was present. The variance explained by the latent factor is 65.9%. In addition, the variable with the highest impact in the "F2-Occlusion-parafunction-psychology " sub-factor is Item I8, which is about the habit of clenching or grinding teeth. The variance explained by the latent factor is 45.6%. Conclusions: According to the results obtained, the reliability and consistency of the FAI scale was ensured. Considering all the fit criteria, it turned out that the proposed model was valid for the sample. The results of the confirmatory factor analysis indicated that the data provided a good fit to the proposed model, as evidenced by the RMSEA, SRMR, GFI, AGFI, CFI, NFI, NNFI, TLI, CR, and AVE indices. It is thought that the application of different physiotherapy techniques can reduce the problems caused by TMD in patients, make it easier to open the mouth wide, and be effective in controlling teeth clenching and jaw pain.

Anahtar Kelimeler

Confirmatory factor analysis, Dentistry students, Exploratory Factor analysis, Fonseca Anamnestic (FAI) questionnaire, Temporomandibular Joint Disorders

Kaynakça

• Arikan, H., Citaker, S., & Ucok, C. (2023). Psychometric Properties of the Fonseca Anamnestic Index (FAI) for Temporomandibular Disorders: Turkish Version, Responsiveness, Reliability and Validity Study. Disability and Rehabilitation, 17(1), 1–8. https://doi.org/10.1080/09638288.2023.2199221
• Ayalı, A., & Ramoğlu, S. (2015). Kuzey Kıbrısta Diş Hekimliği Fakü ltesi Öğrencilerinde Temporomandibular Eklem Disfonksiyonunun Prevalansı. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi, 24(3), 367–372. https://doi.org/10.17567/dfd.91850
• Bevilaqua-Grossi, D., Chaves, T. C., De Oliveira, A. S., & Monteiro-Pedro, V. (2006). Anamnestic Index Severity and Signs and Symptoms of TMD. Cranio : The Journal of Craniomandibular Practice, 24(2), 112–118. https://doi.org/10.1179/CRN.2006.018
• Byrne, B. M. (2016). Structural Equation Modeling With AMOS: Basic Concepts, Applications, and Programming, 3rd ed. Taylor & Francis.
• Campos, J. A. D. B., Carrascosa, A. C., Bonafé, F. S. S., & Maroco, J. (2014). Severity of Temporomandibular Disorders in Women: Validity and Reliability of the Fonseca Anamnestic Index. Brazilian Oral Research, 28, 16–21. https://doi.org/10.1590/s1806-83242013005000026
• Cebi, A. T., Yilmaz, N., Karayürek, F., & Gülses, A. (2021). Depression and Anxiety Levels in a Group of Elderly with Temporomandibular Disorders. Türk Geriatri Dergisi, 24(3), 397–406. https://doi.org/10.31086/tjgeri.2021.237
• Dos Santos Berni K. C., Dibai-Filho A.V. & Rodrigues- Bigaton D. (2015). Accuracy of the Fonseca Anamnestic Index in the Identification of Myogenous Temporomandibular Disorder in Female Community Cases. Journal of Bodywork and Movement Therapies, 19(3), 404–409. https://doi.org/10.1016/j.jbmt.2014.08.001
• Epker, J., & Gatchel, R. J. (2000). Prediction of Treatment-Seeking Behavior in Acute TMD Patients: Practical Application in Clinical Settings. Journal of Orofacial Pain, 14(4), 303–309. Retrieved from https://www.researchgate.net/publication/12126970_Prediction_of_Treatment-Seeking_Behavior_in_Acute_TMD_Patients_Practical_Application_in_Clinical_Settings
• Fonseca, D. M., Bonfante, G., Valle, A. L., & Freitas, S. F. T. (1994). Diagnostico Pela Anamnese da Disfuncao Craniomandibular. Revista Gaucha de Odontologia, 42(1). Retrieved from https://www-revistargo-com-br.translate.goog/archive.php?_x_tr_sl=pt&_x_tr_tl=en&_x_tr_hl=tr&_x_tr_sch=http
• Fornell, C., & Larcker, D. F. (1981). Evaluating Structural Equation Models with Unobservable Variables and Measurement Error. Journal of Marketing Research, 18(1), 39–50. https://doi.org/10.2307/3151312
• González-Sánchez, B., García Monterey, P., Ramírez-Durán, M. D. V., Garrido-Ardila, E. M., Rodríguez-Mansilla, J., & Jiménez-Palomares, M. (2023). Temporomandibular Joint Dysfunctions: A Systematic Review of Treatment Approaches. Journal of Clinical Medicine, 12(12). https://doi.org/10.3390/jcm12124156
• Greene, C. S. (1994). Temporomandibular Disorders in the Geriatric Population. The Journal of Prosthetic Dentistry, 72(5), 507–509. https://doi.org/10.1016/0022-3913(94)90123-6
• Gulzar, K., Islam, F., Thakur, A. R., Shahzad, S., Haider, S., & Tanveer, H. (2022). Prevalence of TMJ Pain Associated with Stress in Undergraduate University students-A Cross Sectional Study. Pakistan BioMedical Journal, 37–40. https://doi.org/10.54393/PBMJ.V5I4.315
• Hair, J. F. (1998). Multivariate Data Analysis. Prentice Hall
• Huang, C.-C., Wang, Y.-M., Wu, T.-W., & Wang, P.-A. (2013). An Empirical Analysis of the Antecedents and Performance Consequences of Using the Moodle Platform. International Journal of Information and Education Technology, 3, 217–221. https://doi.org/10.7763/IJIET.2013.V3.267.
• Kalamir, A., Bonello, R., Graham, P., Vitiello, A. L., & Pollard, H. (2012). Intraoral Myofascial Therapy for Chronic Myogenous Temporomandibular Disorder: A Randomized Controlled Trial. Journal of Manipulative and Physiological Therapeutics, 35(1), 26–37. https://doi.org/10.1016/j.jmpt.2011.09.004
• Kline, R. B. (2011). Principles and Practice of Structural Equation Modeling. Guilford Publications. Korkmaz, S., Goksuluk, D., & Zararsiz, G. (2014). An R Package for Assessing Multivariate Normality. The R Journal, 6(2), 151–162. https://doi.org/10.32614/RJ-2014-031
• LeResche, L. (1997). Epidemiology of Temporomandibular Disorders: Implications for the Investigation of Etiologic Factors. Critical Reviews in Oral Biology and Medicine : An Official Publication of the American Association of Oral Biologists, 8(3), 291–305. https://doi.org/10.1177/10454411970080030401
• Magnusson, T., Egermark, I., & Carlsson, G. E. (2002). Treatment Received, Treatment Demand and Treatment Need for Temporomandibular Disorders in 35-year-old subjects. Cranio : The Journal of Craniomandibular Practice, 20(1), 11–17. https://doi.org/10.1080/08869634.2002.11746184
• Malikov, I, Erhamza, T.S, Öncel, S. Y. (2024). Kırıkkale Üniversitesi Diş Hekimliği Fakültesi Öğrencilerinde Temporomandibular Eklem Rahatsızlıklarının Sıklığı ve Şiddetinin Değerlendirilmesi. Kirikkale Üniversitesi Tip Fakültesi Dergisi, 26(1).
• Molina-Torres, G., Rodríguez-Archilla, A., Matarán-Peñarrocha, G., Albornoz-Cabello, M., Aguilar-Ferrándiz, M. E., & Castro-Sánchez, A. M. (2016). Laser Therapy and Occlusal Stabilization Splint for Temporomandibular Disorders in Patients With Fibromyalgia Syndrome: A Randomized Clinical Trial. Alternative Therapies in Health and Medicine, 22(5), 23–31. Retrieved from http://www.ugr.es/~alberodr/curriculum/articulos/074.pdf
• Mori, H., Horiuchi, S., Nishimura, S., Nikawa, H., Murayama, T., Ueda, K., Ogawa, D., Kuroda, S., Kawano, F., Naito, H., Tanaka, M., Koolstra, J. H., & Tanaka, E. (2010). Three-dimensional Finite Element Analysis of Cartilaginous Tissues in Human Temporomandibular Joint During Prolonged Clenching. Archives of Oral Biology, 55(11), 879–886. https://doi.org/10.1016/j.archoralbio.2010.07.011
• Nicholson, R. A., Townsend, D. R., & Gramling, S. E. (2000). Influence of a Scheduled-waiting Task on EMG Reactivity and Oral Habits Among Facial Pain Patients and No-pain Controls. Applied Psychophysiology and Biofeedback, 25(4), 203–219. https://doi.org/10.1023/a:1026402720856
• Nitzan, D. W., Kreiner, B., & Zeltser, R. (2004). TMJ lubrication system: its effect on the joint function, dysfunction, and treatment approach. Compendium of Continuing Education in Dentistry (Jamesburg, N.J. : 1995), 25(6), 437–438, 440, 443-4, 449, 471. Retrieved from https://www.researchgate.net/publication/8080597_TMJ_lubrication_system_its_effect_on_the_joint_function_dysfunction_and_treatment_approach
• Nomura, K., Vitti, M., de Oliveira, A. S., Chaves, T. C., Semprini, M., siéssere, S., Hallak, J. E. C., & Regalo, S. C. H. (2007). Use of the Fonseca’s Questionnaire to Assess the Prevalence and Severity of Temporomandibular Disorders in Brazilian Dental Undergraduates. Brazilian Dental Journal, 18(2), 163–167. https://doi.org/10.1590/S0103-64402007000200015
• Okeson, J. P. (2019). Management of Temporomandibular Disorders and Occlusion: Management of Temporomandibular Disorders and Occlusion. Elsevier Health Sciences.
• Öncel, S., & Erdugan, F. (2023). The Impact of COVID-19 Pandemic on Distress Intolerance: Among Panic Buyers in Turkey. International Journal of Statistics in Medical Research, 12, 303–311. https://doi.org/10.6000/1929-6029.2023.12.35
• Ow, R. K. K., Loh, T., Neo, J., & Khoo, J. (1995). Symptoms of Craniomandibular Disorder Among Elderly People. Journal of Oral Rehabilitation, 22(6), 413–419. https://doi.org/10.1111/J.1365-2842.1995.TB00794.X
• Özdinç, S. P., Ata, H. Ms., Selçuk, H. Ms., Can, H. B. Ms., Sermenli, N. Ms., & Turan, F. N. P. (2020). Temporomandibular Joint Disorder Determined by Fonseca Anamnestic Index and Associated Factors in 18- to 27-year-old University Students. Cranio : The Journal of Craniomandibular Practice, 38(5), 327–332. https://doi.org/10.1080/08869634.2018.1513442
• Pallegama, R. W., Ranasinghe, A. W., Weerasinghe, V. S., & Sitheeque, M. A. M. (2005). Anxiety and Personality Traits in Patients with Muscle Related Temporomandibular Disorders. Journal of Oral Rehabilitation, 32(10), 701–707. https://doi.org/10.1111/j.1365-2842.2005.01503.x
• Resende, C. M. B. M. de, Alves, A. C. de M., Coelho, L. T., Alchieri, J. C., Roncalli, A. G., & Barbosa, G. A. S. (2013). Quality of Life and General Health in Patients with Temporomandibular Disorders. Brazilian Oral Research, 27(2), 116–121. https://doi.org/10.1590/s1806-83242013005000006
• Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the Fit of Structural Equation Models: Tests of Significance and Descriptive Goodness-of-Fit Measures. Methods of Psychological Research Online, 8, 23–74. https://doi.org/10.23668/psycharchives.12784
• Shook, C., Jr, D., Hult, G. T. M., & Kacmar, K. (2004). An Assessment of The Use of Structural Equation Modeling in Strategic Management Research. Strategic Management Journal, 25, 397–404. https://doi.org/10.1002/smj.385
• Türken, R., Büyük, S. K., & Yaşa, Y. (2020). Diş Hekimliği Fakültesi Öğrencilerinde Temporomandibular Eklem Rahatsızlıklarının ve Ağız Sağlığı Alışkanlıklarının Değerlendirilmesi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 2, 208–213. https://doi.org/10.31067/0.2018.83
• Valesan, L. F., Da-Cas, C. D., Réus, J. C., Denardin, A. C. S., Garanhani, R. R., Bonotto, D., Januzzi, E., & de Souza, B. D. M. (2021). Prevalence of Temporomandibular Joint Disorders: A Systematic Review and Meta-analysis. Clinical Oral Investigations, 25(2), 441–453. https://doi.org/10.1007/s00784-020-03710-w
• Yaman, D., Alpaslan, C., & Kalaycıoğlu, O. (2021). Investigation of Asymptomatic Temporomandibular Disorders with Fonseca Anamnestic Index in Clinical Practice. Acta Odontologica Turcica, 38(3), 62–67. https://doi.org/10.17214/gaziaot.815831