Joseph F. Joor

Vollständiger Abstract

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<h4>Background</h4>Temporomandibular disorders (TMD) have the potential to progress to a chronic form associated with various comorbidities. Prolonged symptoms may lead to central sensitization (CS), resulting in decreased treatment response and highlighting the need for personalized treatment strategies.<h4>Objective</h4>This study evaluated psychological conditions and comorbidities in TMD patients based on CS-related symptom levels measured by the Central Sensitization Inventory (CSI) and investigated the association between these levels and long-term treatment outcomes.<h4>Materials and methods</h4>CS-related symptom levels were assessed using the CSI in 112 TMD patients (score ≥ 40 indicating significant levels of CS symptoms). Psychological, sleep, autonomic and pain-related comorbidities were evaluated by validated questionnaires. Participants received standardized conservative treatment, including behavioural, physical, stabilization splint and pharmacological therapies. After 6 months, patients were re-evaluated for clinical signs. Data were statistically compared between the high (n = 40) and low (n = 72) CSI groups and associations between clinical characteristics and CSI levels were analyzed. Longitudinal changes were analyzed using Generalized Estimating Equations.<h4>Results</h4>High CSI (35.7%) was associated with higher McGill Pain Questionnaire (MPQ) scores, widespread pain and higher levels of anxiety, depression, somatization and autonomic symptoms (all p adj < 0.05 after Bonferroni correction). At 6-month follow-up, the high CSI group showed a trend toward a smaller reduction in pain (group × time interaction, χ 2 = 5.587, p = 0.018), suggesting a potentially less favourable treatment response to conservative therapy.<h4>Conclusion</h4>TMD patients with higher CSI scores exhibit more multidimensional comorbidities and diminished response to conservative therapy. Early identification of CS-related symptoms may be beneficial for establishing personalized treatment strategies.

Abstract: PubMed · Datensatz