質問表を用いた咬合処置の有効性に関する顎関節内障患者の遠隔予後調査

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  • A Longitudinal Follow-up Study on the Effectiveness of the Occlusal Treatments on Temporomandibular Disorder Symptomatology

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The purpose of this study was to evaluate the effect of occlusal treatments on the symptoms of temporomandibular disorders (TMD) by a patient's self-report. Two hundred and sixty-six consecutive TMD patients who had been finished their treatment in our TMD clinic from April 1985 to March 1995 were included in this study. Self-administered questionnaires were sent to patients and 177 (80.0%) patients returned them. These patients were divided into two groups. One was an occlusal treatments (OT) group with ADDWR and ADDWoR (mean age: 44.1±15.5, male/female=6/37, mean age: 48.6±16.7, male/fema le=1/43) who received some sorts of occlusal treatment (e.g., selective tooth grinding, prosthetic and orthodontic jaw repositioning therapy). The other was a non-occlusal treatments (NT) group with ADDWR and ADDWoR (mean age: 32.2±16.2, male/female=17/29, mean age: 36.5±13.9, male/female=7/37) who did not receive any occlusal treatments. The prevalence of self-reported pain in the orofacial region at the first visit was 51.2%, 95.6% in the OT group, and 70.2%, 84.1% in the NT group. The questionnaire included a visual analogue scale of pain (VAS), maximum range of opening (MRO), patient's self-estimation of their treatment outcome (TO score) and daily activity limitation attributable to their TMD symptoms (DAL score). As the result, we could not find any statistically significant difference between the two groups in the three variables (Mann-Whitney U-test). But TO score could find statistically significant in ADDWR (Mann-Whiteney U-test, p<0.05). These results suggest that occulusal treatment might not always be necessary in the TMD treatment modality and even without any occlusal treatment the patients could get substantially enough functionality in their daily lives.

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