TMD patient profiles and care outcomes

Op 27 maart 2018 heeft Naichan Su met succes zijn proefschrift ‘Patient profiles and outcomes of care in temporomandibular disorders’ verdedigd aan de Universiteit van Amsterdam. Het onderzoek werd uitgevoerd onder leiding van prof. dr. G.J.M.G van der Heijden en prof. dr. F. Lobbezoo. Naichan Su ontving een bijdrage van de NVGPT in de kosten van de promotie. Hieronder volgt een samenvatting van het proefschrift.

Temporomandibular disorders (TMD) are common conditions in the general population. The aim of this PhD thesis was to increase the knowledge that is available to date, about patient profiles and outcomes in care of TMD and to help clinicians make decisions on the diagnosis and treatment management of TMD patients.
In the thesis, it is concluded that:
● Arthrocentesis with hyaluronic acid (HA) injection with oral glucosamine hydrochloride (GH) was effective in improving oral health-related quality of life (OHRQoL) of patients with temporomandibular joint osteoarthritis (TMJ OA) up to 6-month follow-up;
● Patients with TMJ OA with more severe symptoms were likely to have lower OHRQoL;
● Two prediction models were developed to predict low OHRQoL of patients with TMJ OA in 1- and 6-month follow-up after arthrocentesis with HA injections. Patients’ age, history of mental disease, pain in other joints, maximal protrusion to the jaw, muscular and joint pain with palpation, awake bruxism, sleep bruxism, chewing-side preference, and OHRQoL at baseline were the most important predictors for OHRQoL at follow-up. Both models proved to accurately predict which patients have low OHRQoL in the follow-up after the treatment;
● Somatization was an important predictor for pain intensity, while depression was an important predictor for pain-related disability in TMD patients;
● A prediction model was developed for types of treatment indicated for TMD patients, notably no treatment, physical treatment only and combined physical and psychological treatment. Patients’ age, gender, sleep bruxism, diagnosis of TMD, stress, depression, anxiety, and stretch of assisted mouth opening were the most important predictors for the types of treatment. The model proved to accurately predict which treatment is indicated to which patients;
● Ultrasonography was a good imaging tool to supplement clinical examination findings for the diagnosis of disc displacements of TMJ based on a systematic review.