Temporomandibular Disorders, Sleep Bruxism, and Primary Headaches Are Mutually Associated
Temporomandibular Disorders, Sleep Bruxism, and Primary Headaches Are Mutually Associated
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DOI：
10.11607/jop.921
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发表时间：
2013-12-01
影响因子：
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通讯作者：
Camparis, Cinara Maria
中科院分区：
文献类型：
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作者：
Fernandes, Giovana;Franco, Ana Lucia;Camparis, Cinara Maria
目标：研究颞下颌关节紊乱病（TMD）、睡眠磨牙症和原发性头痛之间的关系，评估有或无疼痛性TMD和睡眠磨牙症患者原发性头痛的发生风险。方法：样本包括301名个体（253名女性和48名男性），年龄从18岁到76岁不等，平均年龄为37.5岁。颞下颌关节紊乱病的研究诊断标准被用于TMD的分类。根据美国睡眠医学学会提出的临床标准诊断睡眠磨牙症，根据国际头痛疾病分类-II诊断原发性头痛。数据采用卡方检验和比值比检验进行分析，置信区间为95%，采用的显著性水平为0.05。结果：疼痛性TMD、偏头痛和紧张型头痛之间存在相关性（P <0.01）。慢性偏头痛的关联程度更高（比值比= 95.9; 95%置信区间= 12.51-734.64），其次是发作性偏头痛（7.0; 3.45-14.22）和发作性紧张型头痛（3.7; 1.59-8.75）。关于睡眠磨牙症，只有慢性偏头痛与睡眠磨牙症有显著相关性（3.8; 1.83-7.84）。当样本按睡眠磨牙症和疼痛性TMD的存在进行分层时，只有睡眠磨牙症的存在不会增加任何类型头痛的风险。存在疼痛性TMD而无睡眠磨牙症的患者，其风险显著增加，尤其是慢性偏头痛（30.1; 3.58-252.81），其次是阵发性偏头痛（3.7; 1.46-9.16）。疼痛性TMD和睡眠磨牙症之间的关联显著增加了慢性偏头痛的风险（87.1; 10.79-702.18），其次是发作性偏头痛（6.7; 2.79-15.98）和发作性紧张型头痛（3.8; 1.38-10.69）。结论：睡眠磨牙症和疼痛性TMD的关联大大增加了发作性偏头痛、发作性紧张型头痛的风险，尤其是慢性偏头痛。
Aims: To investigate the association among temporomandibular disorders (TMD), sleep bruxism, and primary headaches, assessing the risk of occurrence of primary headaches in patients with or without painful TMD and sleep bruxism. Methods: The sample consisted of 301 individuals (253 women and 48 men) with ages varying from 18 to 76 years old (average age of 37.5 years). The Research Diagnostic Criteria for Temporomandibular Disorders were used to classify TMD. Sleep bruxism was diagnosed by clinical criteria proposed by the American Academy of Sleep Medicine, and primary headaches were diagnosed according to the International Classification of Headache Disorders-II. Data were analyzed by chi-square and odds ratio tests with a 95% confidence interval, and the significance level adopted was .05. Results: An association was found among painful TMD, migraine, and tension-type headache (P < .01). The magnitude of association was higher for chronic migraine (odds ratio = 95.9; 95% confidence intervals = 12.51-734.64), followed by episodic migraine (7.0; 3.45-14.22) and episodic tension-type headache (3.7; 1.59-8.75). With regard to sleep bruxism, the association was significant only for chronic migraine (3.8; 1.83-7.84). When the sample was stratified by the presence of sleep bruxism and painful TMD, only the presence of sleep bruxism did not increase the risk for any type of headache. The presence of painful TMD without sleep bruxism significantly increased the risk in particular for chronic migraine (30.1; 3.58-252.81), followed by episodic migraine (3.7; 1.46-9.16). The association between painful TMD and sleep bruxism significantly increased the risk for chronic migraine (87.1; 10.79-702.18), followed by episodic migraine (6.7; 2.79-15.98) and episodic tension-type headache (3.8; 1.38-10.69). Conclusion: The association of sleep bruxism and painful TMD greatly increased the risk for episodic migraine, episodic tension-type headache, and especially for chronic migraine.