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. 2015 Mar;94(3 Suppl):79S-86S.
doi: 10.1177/0022034514565793. Epub 2015 Jan 8.

Temporomandibular joint disorders' impact on pain, function, and disability

P Chantaracherd  1 , M T John  2 , J S Hodges  3 , E L Schiffman  1
Affiliations

Temporomandibular joint disorders' impact on pain, function, and disability

P Chantaracherd et al. J Dent Res. 2015 Mar.

Abstract

The aim of this study was to determine the association between more advanced stages of temporomandibular joint (TMJ) intra-articular disorders ("TMJ intra-articular status"), representing a transition from normal joint structure to TMJ disc displacement with and without reduction (DDwR and DDwoR) to degenerative joint disease (DJD), and patient-reported outcomes of jaw pain, function, and disability ("TMD impact"). This cross-sectional study included 614 cases from the RDC/TMD Validation Project with at least one temporomandibular disorder (TMD) diagnosis. TMJ intra-articular status was determined by 3 blinded, calibrated radiologists using magnetic resonance imaging and computed tomography as one of normal joint structure, DDwR, DDwoR, or DJD, representing the subject's most advanced TMJ diagnosis. TMD impact was conceptualized as a latent variable consisting of 1) pain intensity (Characteristic Pain Index from the Graded Chronic Pain Scale [GCPS]), 2) jaw function (Jaw Functional Limitation Scale), and 3) disability (Disability Points from GCPS). A structural equation model estimated the association of TMJ intra-articular status with the latent measure TMD impact as a correlation coefficient in all TMD cases (n = 614) and in cases with a TMD pain diagnosis (n = 500). The correlations between TMJ intra-articular status and TMD impact were 0.05 (95% confidence interval [CI], -0.04 to 0.13) for all TMD cases and 0.07 (95% CI, -0.04 to 0.17) for cases with a pain diagnosis, which are neither statistically significant nor clinically relevant. Conceptualizing worsening of TMJ intra-articular disorders as 4 stages and characterizing impact from TMD as a composite of jaw pain, function, and disability, this cross-sectional study found no clinically significant association. Models of TMJ intra-articular status other than ours (normal structure → DDwR → DDwoR → DJD) should be explored.

Keywords: craniomandibular disorders; musculoskeletal system; myofascial pain syndromes; osteoarthritis; pain perception; temporomandibular joint dysfunction syndrome.

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Conflict of interest statement

The authors declare no potential conflicts of interest with respect to the authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Means ± standard deviations for Characteristic Pain Intensity (CPI; 0 to 100), Jaw Functional Limitation Scale (JFLS; 0 to 200), and jaw disability scores (0 to 100) for all temporomandibular disorder (TMD) cases (blue bars) and for TMD cases with a pain diagnosis only (gray bars). DJD, degenerative joint disease; DDwR, disc displacement with reduction; DDwoR, disc displacement without reduction.
Figure 2.
Figure 2.
Structural equation model for the association between temporomandibular joint (TMJ) intra-articular status and temporomandibular disorder (TMD) impact. The oval represents the latent factor TMD impact; the rectangles represent measured indicators for the latent factor with their error variances (circles) or the measured exposure variable TMJ intra-articular status. The lines connecting the latent factor to indicators are factor loadings, and the line connecting the exposure variable TMJ intra-articular status to the latent outcome TMD impact is the correlation between exposure and the latent factor. Numbers provided are standardized values. Analyses were performed with Stata 12 (StataCorp LP, College Station, TX, USA) and used a maximum likelihood estimation, assuming jaw pain, function, and disability items were continuous.
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References

    1. Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, John MT, Schiffman EL. 2009. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 107(6):844–860. - PMC - PubMed
    1. Anderson GC, John MT, Ohrbach R, Nixdorf DR, Schiffman EL, Truelove ES, List T. 2011. Influence of headache frequency on clinical signs and symptoms of TMD in subjects with temple headache and TMD pain. Pain. 152(4):765–771. - PMC - PubMed
    1. Bertram S, Rudisch A, Innerhofer K, Pümpel E, Grubwieser G, Emshoff R. 2001. Diagnosing TMJ internal derangement and osteoarthritis with magnetic resonance imaging. J Am Dent Assoc. 132(6):753–761. - PubMed
    1. Boering G. 1966. Temporomandibular joint arthrosis: an analysis of 400 cases [dissertation]. Groningen, the Netherlands: University of Groningen.
    1. Brown TA. 2012. Confirmatory factor analysis for applied research. New York (NY): Guilford.

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