Trismus and oral health conditions during diagnosis of malignant oral neoplasms

Abstract Introduction: Trismus has been considered a late complication of cancer treatment. It can occur prior to treatment, mainly caused by tumor invasion or muscle spasms induced by the presence of the tumor. Objective: In this study, we evaluated the incidence of trismus and its effect on oral health in patients with malignant neoplasms of the oral cavity before performing the cancer treatment. Methods: This review was carried out via interviews, visual clinical inspection and objective measurement of maximal mouth opening in 35 consecutive patients. Trismus was defined as a maximal mouth opening <35 mm. Results: Trismus was observed in 15 patients, with a total incidence of 42%. A high rate of tooth loss was recorded, and trismus association with tooth loss was statistically verified using the Chi-square and Fisher's exact tests, the t-student test and Mann-Whitney non-parametric test. All tests were performed at p < 0.05. Conclusion: Edentulous patients are eight times more likely to have trismus compared to patients that are partially and fully dentate. Trismus was demonstrated to be correlated with tooth loss; however other oral health conditions were not shown to be a modifying factor.

引言：牙关紧闭（trismus）曾被视为癌症治疗的晚期并发症。该病症亦可出现于治疗前，主要由肿瘤侵袭或肿瘤存在诱发的肌肉痉挛所致。
目的：本研究针对口腔恶性肿瘤患者，在其接受癌症治疗前，评估牙关紧闭的发生率及其对口腔健康的影响。
方法：本研究对35例连续性患者开展访谈、可视临床检查以及最大张口度的客观测量。本研究将最大张口度小于35mm定义为牙关紧闭。
结果：15例患者被检出牙关紧闭，总发生率为42%。本研究记录到较高的牙齿缺失率，并通过卡方检验、Fisher确切概率法、t检验以及曼-惠特尼非参数检验证实了牙关紧闭与牙齿缺失之间存在统计学关联，所有检验均以P<0.05作为显著性判定标准。
结论：无牙颌患者发生牙关紧闭的风险是部分牙列及全牙列患者的8倍。本研究证实牙关紧闭与牙齿缺失存在相关性，但未发现其他口腔健康状况可作为该病的影响修饰因素。