Patients profiles and outcomes of care in temporomandibular disorders

Temporomandibular disorders (TMDs) are a frequent disease in general population. Patients with TMDs may have orofacial pain, jaw functional limitation and joint sounds, which may negatively affect patients’ physical and psychological wellbeing. Temporomandibular joint osteoarthritis (TMJ OA) and disc displacements (DDs) are important subtypes of TMDs. The aim of the thesis is to increase the currently available knowledge about patients profiles and outcomes of care in temporomandibular disorders (TMDs). This thesis contained six main chapters. In Chapter 2, the improvement of oral health related quality of life (OHRQoL) after arthrocentesis with hyaluronic acid (HA) injection with oral glucosamine hydrochloride (GH) was found in patients with TMJ OA. In Chapter 3, the severity of clinical symptoms and signs were significantly associated with OHRQoL of patients with TMJ OA. In Chapter 4, two prediction models for OHRQoL of patients with TMJ OA at 1-month and 6-month after arthrocentesis with HA injections were developed and validated. In Chapter 5, somatization was the best predictor for pain intensity while depression was the best predictor for pain-related disability when several psychological and socio-demographic factors were taken into consideration. In Chapter 6, a prediction model for types of treatment indicated for TMD patients was developed and validated. In Chapter 7, ultrasonography (US) was proved to be a good imaging tool to supplement clinical examination findings for the diagnosis of DDs of temporomandibular joints based on a systematic review. The thesis can provide important information with clinicians for the decision-decision of treatment and prognosis for TMD patients.