顎関節症質問表と症型との関連性に対する統計学的解析

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To defermine the influence of subjective symptoms of patients with temporomandibular (TM) arthrosis on the classification of the case into type of pathological state, and the correlation of these subjective symptoms with objective symptoms peculiar to each type of TM arthrosis, a statistical study was made using multivarliate analysis. The cases studied were 297 patients, 87 males and 210 females, who were clinically diagnosed as TM arthrosis between April 1987 and June 1990 at the Second Department of Oral and Maxillofacial Surgery, Fukuoka Dental College. Questionnaires consisting of 60 questions prepared for those with TM disorders were given at the first visit prior to the physical and radiographical examination in order survery the subjective symptoms. From the physical and radiographical examinations, all the cases were definitely classified into seven types, excluding the cases indicating mental factor, according to a modified classification proposed by the Japanese Society of Temporomandibular Joint (1987). Answers to the questionnaires were scored and multiple discriminant analysis and latent class analysis were performed. The questions considered to be effective for classification into four types were items relating to pain, joint sounds, trisums, habits, and concomitant symptoms such as headache, dizziness or vertigo in the past history. Type I, II and III a could be discriminated from other types by the patient's subjective symptoms. Type I, II, IIIc and IV showed deviated age and sex distributions. For the discrimination of type I, The questions about concomitant symptoms in other regions were considered to be important. For discrimination of types IIIb and IIIb+IV, symptoms such as pain, and trismus were more omportant than over questions about concomitant symptoms in other regions. Morbid types involving type IIIb+IV showed high rate of misdiscrimination. Symptoms peculiar to type IV were considered to be weaker or diversified compared with those of other types. The discrimination between types I and IIIb from patient's subjective symptoms was considered to be difficult. When the patient showed strong consiouness of pain, the organic change of dyskinesia of the articular disc was shown masked. Type IIIc showed a slight male-predominance, and patients therewith had no strong conciousness of trismus. Types I and IV patients took a characteristic pattern of answering questions about the 3 major symptoms and otherwise, respectively. Type IIIb patients, presenting with clicking answeredin a pattern similar to the type I patients. Type I and IIIb patients had a similarity of subjective symptoms of trismus. The questions on possible past history of closed lock and patient's self-release thereof were difficult for the patient to understand.
福岡歯科大学学会の論文
1991-10-30

顎関節症質問表と症型との関連性に対する統計学的解析

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