顎関節症のスクリーナーとしての典型的な5つの症状の有効性

Viability of the quintessential 5 temporomandibular disorder symptoms as a TMD screener.

抄録

目的:

本研究では、顎関節症の診断基準（DC/TMD）の5つの顎関節症の症状（5Ts）を顎関節症スクリーナーとして使用することの有効性を検討した。

OBJECTIVE: This study explored the viability of using the 5 temporomandibular disorder (TMD) symptoms (5Ts) of the Diagnostic Criteria for TMDs (DC/TMD) as a TMD screener.

研究デザイン:

第三次歯科病院の成人（18歳以上）1039名（平均年齢32.65±12.95歳、女性77.4％）が登録された。5Ts質問票（顎関節症／顔面痛、頭痛、顎関節雑音、閉塞性・開塞性に関する項目を含む）を実施し、臨床的な問診・検査、X線検査、DC/TMD診断アルゴリズムおよび診断ツリーを用いて顎関節症の診断を行った。5Tsの診断精度は，受信者動作特性曲線下の面積や，感度，特異度，予測値，尤度比などの各種指標を用いて評価した。

STUDY DESIGN: A total of 1039 adults (≥18 years old) with a mean age of 32.65 ± 12.95 years (77.4% women) from a tertiary dental hospital were enrolled. The 5Ts questionnaire (involving items on TMD/facial pain, headaches, temporomandibular joint noises, and closed- and open-locking) was administered, and TMD diagnoses were derived through clinical interviews and examinations, radiographic investigations, and the DC/TMD diagnostic algorithms and diagnostic tree. Diagnostic accuracy of the 5Ts was assessed using the area under the receiver operating characteristics curve and various measures, including sensitivity, specificity, predictive values, and likelihood ratios.

結果:

参加者のうち、80.2%(n=833)が5Ts陽性、19.8%(n=206)が5Ts陰性で、51.3%と85.7%がそれぞれ1つ以上の疼痛関連診断と関節内DC/TMD診断を受けていた。5Tは、疼痛関連および関節内のすべてのTMDの検出に高い精度を示し、受信者動作特性曲線下の面積は、それぞれ0.98、1.00、0.98であった。感度は96.1%から99.2%であり、特異度は100.0%であった。

RESULTS: Among the participants, 80.2% (n = 833) were 5Ts-positive, and 19.8% (n = 206) were 5Ts-negative, whereas 51.3% and 85.7% received at least 1 pain-related and intra-articular DC/TMD diagnosis, respectively. The 5Ts showed high accuracy for detecting all TMDs, pain-related and intra-articular, with area under the receiver operating characteristics curves of 0.98, 1.00, and 0.98, respectively. Sensitivity ranged from 96.1% to 99.2%, whereas specificity was 100.0%.

結論:

5Tsは，痛みや関節内の障害を識別するための高い診断精度を示した。

CONCLUSIONS: The 5Ts demonstrated high diagnostic accuracy for identifying pain-related and/or intra-articular disorders.