Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Prevalence of Signs and Symptoms of Temporomandibular disorders with aging

연령에 따른 턱관절장애의 증상과 징후의 유병률

  • Chang, Joo-Yeon (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University) ;
  • Kang, Soo-Kyung (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University) ;
  • Auh, Q-Schick (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University) ;
  • Hong, Jung-Pyo (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University) ;
  • Chun, Yang-Hyun (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University)
  • 장주연 (경희대학교 치의학전문대학원 안면통증구강내과학교실) ;
  • 강수경 (경희대학교 치의학전문대학원 안면통증구강내과학교실) ;
  • 어규식 (경희대학교 치의학전문대학원 안면통증구강내과학교실) ;
  • 홍정표 (경희대학교 치의학전문대학원 안면통증구강내과학교실) ;
  • 전양현 (경희대학교 치의학전문대학원 안면통증구강내과학교실)
  • Received : 2012.06.05
  • Accepted : 2012.07.10
  • Published : 2012.09.30
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Abstract

Previous studies of the relationship of TMJ signs and symptoms in elderly people have provided inconsistent findings. The objective of this study was to retrospectively analyze the prevalence of signs and symptoms of temporomandibular disorders(TMD). Additionally, young subjects were examined as a control group. Forty old patients (28 female, 12 male, mean age: $65.2{\pm}2.5$ years) and forty young patients (30 female, 10 male, mean age: $23.3{\pm}2.6$ years) clinically diagnosed with TMD were screened. Patient records were analyzed regarding: pain on chief complain, amount of range of mouth opening, TMJ noises(clicking sounds, crepitus), pain on palpation of the TMJ and masticatory muscles and neck and upper back muscles. Differences between the groups were assessed using t-test and the chi-squared test. (SPSS v.17) P value <0.05 was considered statistically significant. Geriatric subjects more often exhibited crepitus on mouth opening (25%), muscular palpation pain of masseter muscles (82.5%) and temporal muscles(60%). In contrast, young subjects more frequently exhibited joint sounds (62.5%), more amount of range of passive mouth opening (p=0.043). It was found that the younger subjects (82.5%) and the older subjects (87.5%) suffered from subjective sign (orofacial pain on chief complain). There were not statistically significant relationships between orofacial pain (VAS) and the groups. Differences between the groups with respect to joint sounds, muscular palpation pain and mandibular range of motion were significant. Although older subjects more frequently exhibited objective signs (crepitus on opening, pain on muscular palpation) of TMD, younger subjects more frequently objective signs (clicking sound on mouth opening, amount of mandibular range of motion).

노인층에서의 턱관절장애의 증상과 징후에 관한 이전 연구에서 일관된 결론을 제시하지 못하고 있다. 본 연구의 목적은 연령에 따른 턱관절의 증상과 징후의 유병률을 분석하는 것이다. 젊은층을 대조군으로 평가하였다. 40명의 노인층 환자 (28명 여자, 12명 남자, 평균연령: $65.2{\pm}2.5$)와 40명의 젊은층 환자 (30명 여자, 10명 남자, 평균연령: $23.3{\pm}2.6$)로서 턱관절장애(temporomandibular disorders, TMD)로 진단받은 질환자를 대상으로 하였다. 실험 대상자는 다음과 같은 평가기준을 적용하였다. 주관적 평가인 주소에서 구강안면 통증의 정도(VAS), 객관적인 평가에서 하악 개구 시 운동량, TMJ 관절잡음 (관절음, 염발음), TMJ 촉진 시 통증, 저작과 관련된 근육(교근, 측두근)과 목 근육, 견부근의 촉진 시 통증에 관한 것을 포함한다. 두 그룹 간 차이점 분석은 t 검정과 카이제곱 검정 방법을 사용하였다. (SPSS v. 17) P 값이 0.05 이하인 것을 통계적으로 유의성 있게 보았다. 주관적인 평가에서 주소에 나타난 구강안면 통증 정도에서는 두 그룹 간 유의한 차이는 발견되지 않았다. 객관적인 평가에서 노인층 환자에서 개구 시 염발음이 25%에서 관찰되었고 저작근 촉진 시 통증은 82.5%에서 관찰되었으며 측두근 촉진시에 60%에서 통증을 보였다. 반대로, 젊은층에서 62.5%에서 관절잡음이 관찰되었고 개구 시 좀 더 큰 운동량을 보였다. (p=0.043) 관절잡음과 촉진 시 근육 통증, 하악 운동량에서 두 그룹 간 차이는 현저했다. 노인층에서 TMD에 대한 개구 시염발음, 근육 촉진 시 통증이 자주 관찰되는 반면 젊은 층에서는 하악 운동 시 관절잡음, 운동 시 개구량의 증가가 보다 많이 관찰되었다.

Keywords

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