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Association Between Macro and Micro Traumatic Events and Temporomandibular Disorders: A Retrospective Study
Ort / Verlag
ProQuest Dissertations & Theses
Erscheinungsjahr
2023
Beschreibungen/Notizen
Introduction: Temporomandibular disorders (TMD) are the most common non-dental cause of orofacial pain which often occurs following micro or macro trauma. Musculoskeletal microtrauma is defined as damage to the tissue by constant exposure to low-magnitude forces (parafunctional habits etc.) whereas macro trauma refers to any direct or indirect injury to the jaw following a whiplash or vehicle accident, or prolonged mouth opening affecting tissue integrity.Aim: Overall, the thesis aims to report and compare the TMD patient’s characteristics, self-reported signs, and symptoms, clinical signs and examination findings, preceding events specifically micro and macro trauma as well as their association with TMD diagnosis and symptom severity. The primary aim is to assess the association of micro and macro traumatic events and temporomandibular disorders with the secondary aim to report the patient demographics, TMD-related history as well as symptomatic characteristics.Methods: A retrospective study was conducted using the medical records of 465 patients visiting the Orofacial Pain and TMD clinic at Montreal General Hospital. Patients aged ≥15 years with a confirmed diagnosis of TMD based on DC/TMD criteria and without any pre-existing orofacial syndrome. Patient demographic, self-reported complaints, and clinical examination were evaluated. Patients were divided into 4 groups: Macro trauma, Micro trauma, Both and no trauma history. Patient characteristics, symptom severity, clinical signs, and diagnosis between the two groups were compared using the chi-square test and One-way ANOVA. P-value ≤0.05 was considered statistically significant.Results: Our sample population consists of 75.6% females and 24.4% males with the mean age of our sample population being 45.39. More than fifty percent of the patients reported pain in TMJ or jaw as the reason for consultation. Macro trauma was the cause of TMD among 210 patients and 59.1% of the total population reported parafunctional habits. A statistically significant (p ≤ 0.05) association was found between reporting micro and macro traumatic events and TMD symptom severity. Micro trauma history was associated with TMD diagnosis. Although there was no association between macro trauma and type of TMD diagnosis, patients with macro trauma history had more severe TMD clinical signs and self-reported symptoms.Conclusion: We conclude that different types of traumatic events play a role in TMD development and patient’s with micro/macro traumatic event history present with different patient-reported and clinical manifestations compared to those without any preceding event. Thorough patient history recording and clinical examination of TMD patients will help develop more effective and efficient preventive treatments, especially for those with facial trauma history, and will ultimately reduce patient discomfort, and treatment cost and improve quality of life.