Profiling the clinical presentation of diagnostic characteristics of a sample of symptomatic TMD patients

Abstract

BackgroundTemporomandibular disorder (TMD) patients might present a number of concurrent clinical diagnoses that may be clustered according to their similarity. Profiling patients’ clinical presentations can be useful for better understanding the behavior of TMD and for providing appropriate treatment planning. The aim of this study was to simultaneously classify symptomatic patients diagnosed with a variety of subtypes of TMD into homogenous groups based on their clinical presentation and occurrence of comorbidities.MethodsClinical records of 357 consecutive TMD patients seeking treatment in a private specialized clinic were included in the study sample. Patients presenting multiple subtypes of TMD diagnosed simultaneously were categorized according to the AAOP criteria. Descriptive statistics and two-step cluster analysis were used to characterize the clinical presentation of these patients based on the primary and secondary clinical diagnoses.ResultsThe most common diagnoses were localized masticatory muscle pain (n = 125) and disc displacement without reduction (n = 104). Comorbidity was identified in 288 patients. The automatic selection of an optimal number of clusters included 100% of cases, generating an initial 6-cluster solution and a final 4-cluster solution. The interpretation of within-group ranking of the importance of variables in the clustering solutions resulted in the following characterization of clusters: chronic facial pain (n = 36), acute muscle pain (n = 125), acute articular pain (n = 75) and chronic articular impairment (n = 121).ConclusionSubgroups of acute and chronic TMD patients seeking treatment can be identified using clustering methods to provide a better understanding of the clinical presentation of TMD when multiple diagnosis are present. Classifying patients into identifiable symptomatic profiles would help clinicians to estimate how common a disorder is within a population of TMD patients and understand the probability of certain pattern of clinical complaints.

Identifying potential predictors of pain–related disability in Turkish patients with chronic temporomandibular disorder pain

“…In contrast, we did not find that treatment-seeking was a predictor of high disability. Studies suggested that profiling patients' clinical presentations and psychological status can be useful for a better understanding of the treatment-seeking behavior of TMD and for providing appropriate treatment planning [8,9,11,16,20,23,25,26],[44,53]. Additional studies are needed for determining the clinical and psychological factors related to treatment-seeking behaviors in TMD patients with chronic pain.…”

The effect of a short term conservative physiotherapy versus occlusive splinting on pain and range of motion in cases of myogenic temporomandibular joint dysfunction: a randomized controlled trial

“…The number of patients suffering from temporomandibular joint dysfunction (TMD) has been increased dramatically 1 ) . It has been reported that 8 out of 10 patients seek health care primarily from a dentist complaining of symptoms that are diagnosed as bruxism or TMD 2 ) . TMD is known as a group of disorders that affect the temporomandibular joint (TMJ), the masticatory system, or both, and may even extend to involve the surrounding related structures 3 ) .…”

Central Sensitization-Based Classification for Temporomandibular Disorders: A Pathogenetic Hypothesis

“…To date, evidence is inconclusive regarding instrumental biomarkers of TMD based on the anatomic and functional analysis of the stomatognathic system [ 1 , 2 ]. For this reason, it has been suggested that the characteristics of pain in TMD could explain the pathogenesis of the disorder better than other mechanisms [ 3 , 4 ]. For example, the concomitant presence of TMD and headache in many TMD patients suggests a clinical association between the diseases and a possible common pathogenesis of pain [ 5 , 6 ].…”