Highlights
- •DC/TMD head and neck pain drawings contribute to a stratification of TMD patients
- •Spatial extent of facial pain is associated with psychosocial burden in TMD patients
- •Unilateral orofacial pain is an indicator for temporomandibular joint pathologies
Abstract
Head and neck pain drawings have been introduced as part of the diagnostic gold standard
for temporomandibular disorders (TMD). We aimed to quantify the spatial extent of
pain in TMD patients and to analyze its association with further clinical findings.
In a cross-sectional study, 90 patients (median age = 38 years; n women = 68) were
diagnosed according to the DC/TMD. Intra-articular disorders were either confirmed
or rejected by MRI. The patients shaded all painful areas in a sketch of the left
and right side of a face. A grid template was placed over the drawings and each region
that contained markings was scored as painful. The correlation between the calculated
area and the psychosocial variables (DC/TMD axis II) as well as the influence of pain
lateralization were investigated using Spearman correlation, Mann-Whitney-U and Chi-Square
tests. Pain affected all facial areas but concentrated on the regions of the temporomandibular
joint and masseter origin. Thirty-nine percent reported purely unilateral pain, which
was associated with structural TMJ findings in 77% of cases. Individuals with bilateral
pain and those with greater spatial spread of pain had significantly higher scores
on all axis II variables, except for functional limitation of the jaw.
Perspective
Head and neck pain drawings can contribute to a stratification of TMD patients. A
greater extent of pain as well as pain bilateralization is associated with higher
levels of emotional distress, pain chronicity and somatization, but not with functional
impairment. Unilateral reporting of pain is associated with more intraarticular disorders.
Keywords
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Article info
Publication history
Accepted:
January 12,
2023
Received in revised form:
December 31,
2022
Received:
July 12,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Disclosures
No funding sources were provided for this study. The authors declare that there are no conflicts of interest.
Identification
Copyright
© Published by Elsevier Inc. on behalf of United States Association for the Study of Pain, Inc.
