Epidemiological Study on Temporomandibular Disorders Using Research Diagnostic Criteria for TMD (RDC/TMD)

  • Ahn, Ji-Yeon (Department of Orthodontics, Dentistry Section, Seoul National University Bundang Hospital) ;
  • Kim, Jong-Wan (Department of Orthodontics, Dentistry Section, Seoul National University Bundang Hospital) ;
  • Kim, Young-Kyun (Department of Oral and Maxillofacial Surgery, Dentistry Section, Seoul National University Bundang Hospital)
  • Published : 2008.12.30

Abstract

Purpose : This epidemiological research was conducted to investigate the relationship between the groups of TMD and the behavioral, psychological, and physical symptoms through RDC/TMD. Subjects and Methods : The subjects of this research were the 286 patients who had visited Seoul National University Bundang Hospital; their common chief complaint was temporomandibular discomfort. The mean age of the patients was 32.9 from 11 to 85, and the number of men and women was 67 and 219, respectively. The patients were examined through clinical and radiological methods and diagnosed by 1 investigator. They were divided into 3 groups: myogenous group (group 1), arthrogenous group (group 2), and combined group (group 3). The behavioral, psychological, and physical symptoms were evaluated through questionnaires on RDC/TMD. Specific items were selected to calculate the graded chronic pain (characteristic pain intensity, disability points), jaw disability, depression, and non-specific physical symptoms (pain items included/excluded) in the questionnaire. One-way ANOVA, Kruskal-Wallis test, and chi-square test were applied as statistical methods. Results : As a result of classifying temporomandibular disorder in this study, the patients were distributed as follows: 9.1% of group 1, 79.7% of group 2, and 11.2% of group 3. In the analysis of graded chronic pain (characteristic pain intensity, disability points), jaw disability, and non-specific physical symptoms (pain items included/excluded), group 3 had the highest score, and the difference was significant (p<0.001). Moreover, the depression score of group 3 was significantly higher than groups 1 and 2 (p<0.05). Note that that the second order of jaw disability score was group 2, on the other hand, those of the other groups were group 1. Conclusion : Myofascial pain could be assumed to be related closely to the behavioral, psychological, and physical symptoms except jaw disability compared to joint pain through RDC/TMD.

Keywords

References

  1. Okeson JP: Bell's Orofacial pains. The clinical management of orofacial pain. 6th ed. Chicago: Quintessence Pub Co.; 2005.
  2. LeResche L. Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med. 1997; 8: 291-305. https://doi.org/10.1177/10454411970080030401
  3. Okeson JP: Management of temporomandibular disorders and occlusion. 5th ed. St. Louis, Mo.: Mosby; 2003.
  4. Fricton JR, Kroening RJ, Hathaway KM: TMJ and craniofacial pain: diagnosis and management. 1st ed. St. Louis: Ishiyaku EuroAmerica; 1988.
  5. Eversole LR, Stone CE, Matheson D, Kaplan H. Psychometric profiles and facial pain. Oral Surg Oral Med Oral Pathol. 1985; 60: 269-274. https://doi.org/10.1016/0030-4220(85)90310-X
  6. Truelove EL, Sommers EE, LeResche L, Dworkin SF, Von Korff M. Clinical diagnostic criteria for TMD. New classification permits multiple diagnoses. J Am Dent Assoc. 1992; 123: 47-54.
  7. Marbach JJ, Lund P. Depression, anhedonia and anxiety in temporomandibular joint and other facial pain syndromes. Pain. 1981; 11: 73-84. https://doi.org/10.1016/0304-3959(81)90140-8
  8. Greene CS. Managing TMD patients: initial therapy is the key. J Am Dent Assoc. 1992; 123: 43-45. https://doi.org/10.14219/jada.archive.1992.0188
  9. Sessle BJ, Bryant PS, Dionne RA: Temporomandibular disorders and related pain conditions. 2nd ed. Seattle: IASP Press; 1995.
  10. Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy. Pain. 1986; 3(suppl 1): 1-226.
  11. Turk DC, Rudy TE. Toward an empirically derived taxonomy of chronic pain patients: integration of psychological assessment data. J Consult Clin Psychol. 1988; 56: 233-238. https://doi.org/10.1037/0022-006X.56.2.233
  12. Dworkin SF, Sherman J, Mancl L, Ohrbach R, LeResche L, Truelove E. Reliability, validity, and clinical utility of the research diagnostic criteria for Temporomandibular Disorders Axis II Scales: depression, non-specific physical symptoms, and graded chronic pain. J Orofac Pain. 2002; 16: 207-220.
  13. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992; 6: 301-355.
  14. Yap AU, Tan KB, Chua EK, Tan HH. Depression and somatization in patients with temporomandibular disorders. J Prosthet Dent. 2002; 88: 479-484. https://doi.org/10.1067/mpr.2002.129375
  15. Lundeen TF, Sturdevant JR, George JM. Stress as a factor in muscle and temporomandibular joint pain. J Oral Rehabil. 1987; 14: 447-456. https://doi.org/10.1111/j.1365-2842.1987.tb00739.x
  16. Von Korff M, Ormel J, Keefe FJ, Dworkin SF. Grading the severity of chronic pain. Pain. 1992; 50: 133-149. https://doi.org/10.1016/0304-3959(92)90154-4
  17. Auerbach SM, Laskin DM, Frantsve LM, Orr T. Depression, pain, exposure to stressful life events, and long-term outcomes in temporomandibular disorder patients. J Oral Maxillofac Surg. 2001; 59: 628-633. https://doi.org/10.1053/joms.2001.23371
  18. Derogatis LB, Cleary PA. Confirmation of the dimensional structure of the SCL-90: A study in construct validation. J Clin Psychol. 1977; 33: 981-989. https://doi.org/10.1002/1097-4679(197710)33:4<981::AID-JCLP2270330412>3.0.CO;2-0
  19. Epker J, Gatchel RJ. Coping profile differences in the biopsychosocial functioning of patients with temporomandibular disorder. Psychosom Med. 2000; 62: 69-75. https://doi.org/10.1097/00006842-200001000-00010
  20. Lindroth JE, Schmidt JE, Carlson CR. A comparison between masticatory muscle pain patients and intracapsular pain patients on behavioral and psychosocial domains. J Orofac Pain. 2002; 16: 277-283.
  21. Yemm R. A comparison of the electrical activity of masseter and temporal muscles of human subjects during experimental stress. Arch Oral Biol. 1971; 16: 269-273. https://doi.org/10.1016/0003-9969(71)90020-3
  22. Thomas LJ, Tiber N, Schireson S. The effects of anxiety and frustration on muscular tension related to the temporomandibular joint syndrome. Oral Surg Oral Med Oral Pathol. 1973; 36: 763- 768. https://doi.org/10.1016/0030-4220(73)90153-9
  23. Mercuri LG, Olson RE, Laskin DM. The specificity of response to experimental stress in patients with myofascial pain dysfunction syndrome. J Dent Res. 1979; 58: 1866-1871. https://doi.org/10.1177/00220345790580090401
  24. Rao SM, Glaros AG. Electromyographic correlates of experimentally induced stress in diurnal bruxists and normals. J Dent Res. 1979; 58: 1872-1878. https://doi.org/10.1177/00220345790580090501
  25. Sternbach RA. Pain and 'hassles' in the United States: findings of the Nuprin pain report. Pain. 1986; 27: 69-80. https://doi.org/10.1016/0304-3959(86)90224-1
  26. Franks AS. Masticatory muscle hyperactivity and temporomandibular joint dysfunction. J Prosthet Dent. 1965; 15: 1122-1131. https://doi.org/10.1016/0022-3913(65)90188-5
  27. KYDD WL. Psychosomatic aspects of temporomandibular joint dysfunction. J Am Dent Assoc. 1959; 59: 31-44. https://doi.org/10.14219/jada.archive.1959.0146
  28. Hubbard DR, Berkoff GM. Myofascial trigger points show spontaneous needle EMG activity. Spine. 1993; 18: 1803-1807. https://doi.org/10.1097/00007632-199310000-00015
  29. Grzesiak RC. Psychologic considerations in temporomandibular dysfunction. A biopsychosocial view of symptom formation. Dent Clin North Am. 1991; 35: 209-226.
  30. Solberg WK, Flint RT, Brantner JP. Temporomandibular joint pain and dysfunction: a clinical study of emotional and occlusal components. J Prosthet Dent. 1972; 28: 412-422. https://doi.org/10.1016/0022-3913(72)90243-0