PSYCHOSOCIAL STRESS, BRUXISM, AND MYOFASCIAL TMD

描述：这项研究将探讨压力，痛苦和 磨牙症在肌筋膜TMD疼痛加重中的作用 它还将评估 磨牙症在调节常用口服药物疗效中的作用 电器。 该研究将招募85名新入院的TMD诊所， 新泽西医学和牙科大学（UMDNJ） 肌筋膜TMD的诊断标准，且既往未接受过治疗 用口腔矫正器治疗面部疼痛 85名对照组受试者 没有任何TMD的人也将从UMDNJ的非TMD诊所招募。 为了测试压力，痛苦和磨牙症在加重面部疾病中的作用， 疼痛，TMD患者和对照组将完成每日压力日记， 一周的痛苦和悲伤。 在这个时期的开始， 一周后，将进行全口牙印模。 这些印象 将用于准备显微照片，将在扫描下进行检查 电镜 通过检查两者之间划痕的变化 期间，将对受试者磨牙症的严重程度进行分级。 回归模型 将测试压力、痛苦、磨牙症和面部疼痛之间的关系。 分析还将比较TMD患者和对照组磨牙症的严重程度。 为了测试磨牙症在治疗结果中的作用，TMD患者将被 随机分配接受全覆盖硬丙烯酸夹板或 腭夹板 在接下来的一个月的两次随访中，疼痛和 残疾将被评估。 分析将检查 活动夹板与腭夹板之间的关系受患者 有磨牙的迹象

DESCRIPTION: This study will examine the role of stress, distress and bruxism in pain exacerbation in myofascial TMD. It will also evaluate the role of bruxism in moderating the efficacy of a commonly used oral appliance. The study will recruit 85 new admissions to the TMD clinic at the Univ. of Medicine and Dentistry of New Jersey (UMDNJ) who meet diagnostic criteria for myofascial TMD and who have had no prior treatment with oral appliances for facial pain. A group of 85 control subjects without any TMD will also be recruited from the non-TMD clinics at UMDNJ. To test the role of stress, distress, and bruxism in exacerbating facial pain, TMD patients and controls will complete daily diaries of stress, distress and pain for one week. At beginning of this period and exactly one week later, full-mouth dental impressions will be taken. These impressions will be used to prepare micrographs that will be examined under a scanning electron microscope. By examining changes in scratch marks between the two periods, subjects will be graded for severity of bruxism. Regression models will test the relation between stress, distress, bruxism, and facial pain. Analyses will also compare severity in bruxism in TMD patients and controls. To test the role of bruxism in treatment outcome, TMD patients will then be randomly assigned to receive either a full-coverage hard acrylic splint or palatal splint. In two followup visits over the following month, pain and disability will be assessed. Analyses will examine whether the efficacy of the active vs. palatal splint is moderated by the degree to which patients show evidence of bruxism.