Association between severity of the temporomandibular disorder, neck pain, and mandibular function impairment

ABSTRACT Purpose: to investigate the possible association between the severity of the temporomandibular disorder, cervical pain, and mandibular function impairment. Methods: is a cross-sectional, descriptive study, conducted with 32 individuals with temporomandibular disorder, categorized by degree of severity, according to the Fonseca Index. Using the diagnosis criteria for temporomandibular disorder, the likely etiological factors for the disorder were established, as well as the intensity of the functional disability, resulting from cervical pain and of the mandibular impairment. The data obtained were statistically treated, adopting the significance level of 5%. Results: the mean age was 33.8 years, 90.6% being females. As for the degree of disorder, 56.3% presented severe TMD, followed by 28.1% showing a moderate one. The myogenic etiology was present in 93.7% of the patients. Cervical pain was present in 90.6% of them, of which, 59.4% presented a mild disability, and 25%, a moderate one. Considering the mandibular function, 46.9% of the patients presented a low, 40.6%, a moderate, and 12.5%, a severe impairment. There was a statistically significant association between cervical pain and mandibular function (p = 0.011). However, although there was an increase in cervical disability and in mandibular impairment as the severity of the TMD also increased, these associations were not statistically significant (p = 0.178 and p = 0.102, respectively). Conclusion: it can be stated that there is a higher prevalence of severe TMD and of myogenic origin, and that cervical pain influences, directly, the mandibular function, which is not necessarily related to the severity of the temporomandibular alteration. Likewise, such severity does not present a relationship to mandibular function impairment either.

【摘要】目的：探讨颞下颌关节紊乱病（temporomandibular disorder, TMD）严重程度、颈椎疼痛与下颌功能障碍之间的潜在关联。方法：本研究为横断面描述性研究，纳入32名颞下颌关节紊乱病患者，采用丰塞卡指数（Fonseca Index）按疾病严重程度进行分级。依据颞下颌关节紊乱病诊断标准，明确该疾病的潜在致病因素，同时评估颈椎疼痛所致的功能残疾程度与下颌功能受损情况。所获数据采用统计学方法处理，显著性水平设定为5%。结果：研究对象平均年龄为33.8岁，其中女性占比90.6%。按疾病严重程度分级，56.3%的患者为重度颞下颌关节紊乱病，28.1%为中度患者。肌源性致病因素的检出率为93.7%。90.6%的患者存在颈椎疼痛，其中59.4%表现为轻度功能残疾，25%表现为中度功能残疾。就下颌功能状态而言，46.9%的患者存在轻度下颌功能受损，40.6%为中度受损，12.5%为重度受损。颈椎疼痛与下颌功能之间存在统计学意义上的显著关联（p=0.011）。尽管随着颞下颌关节紊乱病严重程度升高，颈椎残疾程度与下颌功能受损程度均呈上升趋势，但上述两项关联均无统计学显著性（分别为p=0.178与p=0.102）。结论：本研究结果表明，重度颞下颌关节紊乱病与肌源性病因的患病率更高；颈椎疼痛可直接影响下颌功能，而该影响未必与颞下颌关节病变的严重程度相关。同理，颞下颌关节紊乱病的严重程度亦与下颌功能障碍无明显关联。