| Aim:To examine and determine whether anxiety,depression and other psychological factors are risk factors for Temporomandibular Disorders,and to evaluate the differences of psychological status among different symptoms and types of TMD and explore the relationship between psychological factors with each group.Materials and Methods:A total of 200 adult patients who were admitted to the orthodontic department of our hospital for the first time from 2018 to 2020 were selected as the research subjects.According to clinical diagnosis,they were divided into TMD group and control group,with 100 cases in each group.At the same time,according to the clinical manifestations of patients,TMD group could be divided into:(1)joint area or(and)masticatory muscle pain group(2)abnormal mandibular movement group(3)Clicking sounds in the joints group(4)two or more symptoms group,these four subgroups;According to the DC/TMD axis I diagnostic table combined with imaging examination(CBCT or MRI),the patients were divided into five subgroups:(1)disc displacement with reduction group(2)disc displacement with reduction,with intermittent locking group(3)disc displacement without reduction,with limited opening group(4)disc displacement without reduction,without limited opening group(5)degenerative joint disease group.GAD-7,PHQ-9 and PHQ-15 were used to evaluate the psychological status of the patients.SPSS 23.0 software was used for statistical analysis of the collected data of each group.Further analysis of the TMD group and the control group as well as different symptoms and different types of TMD patients psychological status differences and to explore whether psychological factors as risk factors.Results:1.Temporomandibular disorders are bidirectional correlation with psychological status.Specifically,the severity of psychological status(anxiety,depression and somatic symptoms)in TMD group was significantly higher than that in control group.Meanwhile,anxiety,depression and somatic symptoms were the risk factors for TMD(P<0.05).2.Among TMD patients with different clinical manifestation types(type 4),there was no significant difference in the mean value of their psychological status and the proportion of population distribution.However,the correlation between different psychological factors and different clinical manifestations of TMD may be different.The concrete analysis results show that physical symptoms are the risk factors for all kinds of clinical symptoms of TMD.Depression is a risk factor for joint clanging and pain.Anxiety was a risk factor for abnormal mandibular movement(P<0.05).3.Among TMD patients with different diagnostic subtypes(type 5),there are significant differences in the mean value of their psychological status and the proportion of population distribution.The results showed that the three psychological conditions were all risk factors for reversible anterior disc displacement(type 1).Depression is a risk factor for reversible disc displacement with rope(type(2))and irreversible anterior disc displacement(type(4)).Somatic symptoms were risk factors for irreversible disc displacement with limited opening(type(3))and osteoarthropathy(type(5))(P<0.05).Conclusions:1.Temporomandibular disorders are bidirectional correlation with psychological status.Compared with the normal population,patients with TMD are more likely to have abnormal psychological status,and abnormal psychological status is a risk factor for TMD.2.Among TMD patients,there was no significant difference in the psychological status of patients with different clinical symptoms;However,abnormal psychological status may be one of the risk factors leading to different clinical symptoms in patients with TMD.3.Among TMD patients,there are differences in the psychological status of patients with different diagnosis types;In addition,abnormal psychological status may be one of the risk factors for TMD patients to develop into different types. |
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