TMD LONGITUDINAL STUDIES--CLINICAL/CHRONIC PAIN SYNDROME

提交此竞争性续期申请以支持继续 TMD纵向研究：临床/慢性疼痛 同步。 总体目标是进行多学科研究， 疼痛和功能障碍的发病、自然史、护理和预防 与颞下颌关节紊乱病（TMD）有关。 研究关注 颞下颌关节紊乱病作为临床实体和功能失调 与TMD相关的慢性疼痛。 TMD指的是一系列 特征在于咀嚼肌疼痛和压痛和/或 颞下颌关节（TMJ），下颌开口受限， 发出咔哒声、爆裂声或摩擦声。 功能失调性慢性疼痛是 定义为中重度慢性复发性疼痛， 限制活动。 功能失调性慢性疼痛与 情绪障碍，患病率上升的行为和受损 扮演重要的社会角色。 拟议的项目将 继续关注TMD作为一个临床实体， 慢性疼痛患者对TMD疼痛的反应及护理对策 TMD疼痛患者的输送系统。 的一个组成部分 研究策略一直是并将继续是比较TMD与 其他常见的慢性疼痛状况，主要是背痛和头痛。 我们建议进行四个项目： 第一个项目将研究自然灾害的性质、决定因素、发展和 预防慢性疼痛行为与TMD，背痛和 头痛. 这项研究将集中在护理相关的慢性疼痛 行为（医疗保健访问和使用止痛药）， 患者进入慢性病角色的行为表现。 的 下一个项目将研究如何提高牙医的知识， 生物医学、行为和心理社会方面的实践 TMD的管理。 教育干预的实验研究 将在执业牙医和牙科学生中进行。 最后一个项目将通过随机对照试验评估 传统平面牙合垫治疗的相对有效性 与夹板疗法的低成本替代方案相比， 位器具制造的病人-和通常的TMD护理没有 夹板疗法 核心项目将包括一个科学核心 提供科学指导、项目协调、设计和分析 资源、综合数据管理和共享科学专业知识。

This competing renewal application is submitted to support continuation of the Program Project TMD Longitudinal Studies: Clinical/Chronic Pain Syndromes. The overall goal is to conduct multidisciplinary research on the onset, natural history, care and prevention of pain and dysfunction associated with temporomandibular disorders (TMD). The research concern temporomandibular disorders as clinical entities and dysfunctional chronic pain associated with TMD. TMD refers to a set of disorders characterized by pain and tenderness in the muscles of mastication and/or the temporomandibular joint (TMJ), limitations of jaw opening and clicking, popping or grating TMJ sounds. Dysfunctional chronic pain is defined as chronic-recurrent pain of moderate-severe intensity that limits activities. Dysfunctional chronic pain is associated wit emotional disturbance, elevated rates of illness behavior and impaired performance of major social roles. The proposed Program Project will continue to focus on TMD as a clinical entity, the adaptation of the chronic pain patient to TMD pain and the response of the health care delivery system to the TMD pain patient. An integral part of the research strategy has been and will continue to be comparison of TMD with other common chronic pain conditions, principally back pain and headache. We propose to carry out four projects: The first Project will study the nature, determinants, development and prevention of chronic pain behaviors associated wit TMD, back pain and headache. This research will focus on care-related chronic pain behaviors (health care visits and use of pain medications) that are behavioral manifestations of patient entry into a chronic sick role. The next project will investigate how to improve dentists' knowledge and practice concerning biomedical, behavioral and psychosocial aspects of the management of TMD. Experimental studies of educational interventions will be carried out among practicing dentists and among dental students. The last project will assess, through a randomized controlled trial, the relative effectiveness of conventional flat plane occlusal splint therapy compared to both a low cost alternative to splint therapy a flat plane bit appliance fabricated by the patient-- and to usual TMD care without splint therapy. A Core Project will consist of a Scientific Core providing scientific direction, project coordination, design and analysis resources, integrated data management, and shared scientific expertise.