A study on the relationship between Axis I and Axis II diagnoses of DC/TMD: A cross-sectional survey of dental students
The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were determined by clinical examination (Axis I) and psychosocial examination (Axis II), but the relation between Axis I and Axis II has not been investigated. The purpose of this study was to clarify the correlation between Axis I and...
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| Published in | Journal of the Japanese Society for the Temporomandibular Joint Vol. 31; no. 2; pp. 106 - 114 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japanese Society for Temporomandibular Joint
20.08.2019
一般社団法人 日本顎関節学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0915-3004 1884-4308 |
| DOI | 10.11246/gakukansetsu.31.106 |
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| Abstract | The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were determined by clinical examination (Axis I) and psychosocial examination (Axis II), but the relation between Axis I and Axis II has not been investigated. The purpose of this study was to clarify the correlation between Axis I and Axis II with a cross-sectional survey.The subjects were 226 students in the fifth grade of Nihon University School of Dentistry at Matsudo (144 males and 82 females, mean age 23.8±2.7). To make a diagnosis for DC/TMD Axis I, subjective symptoms (Yes: Patient (P) group or No: Normal (N) group) on the examination form and the number of tenderness points on palpation were used. As for Axis II, Oral Behavior Checklist (OBC), anxiety (Generalized Anxiety Disorder-7: GAD-7) and depression (Patient Health Questionnaire-9: PHQ-9) were used. The relation between Axis I and Axis II was examined.A significantly larger number of women had subjective symptoms and tenderness points compared to men, but there was no gender difference in the other variables. There was a significant strong correlation (r = 0.745) between GAD-7 and PHQ-9, and a significant weak correlation (r = 0.322) between OBC and the number of tenderness points. The P group had a significantly higher number of tenderness points and PHQ-9 value compared to the N group. Significant odds ratio was found in the number of tenderness point, slight depression level judged by using PHQ-9, and positive answer in 5th question item of OBC as an independent variable with the presence of subjective symptom as a dependent variable.These results suggest that there is a correlation between Axis I and Axis II diagnoses of DC/TMD in studies using dental students without or with slight symptoms of TMD. |
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| AbstractList | The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were determined by clinical examination (Axis I) and psychosocial examination (Axis II), but the relation between Axis I and Axis II has not been investigated. The purpose of this study was to clarify the correlation between Axis I and Axis II with a cross-sectional survey.The subjects were 226 students in the fifth grade of Nihon University School of Dentistry at Matsudo (144 males and 82 females, mean age 23.8±2.7). To make a diagnosis for DC/TMD Axis I, subjective symptoms (Yes: Patient (P) group or No: Normal (N) group) on the examination form and the number of tenderness points on palpation were used. As for Axis II, Oral Behavior Checklist (OBC), anxiety (Generalized Anxiety Disorder-7: GAD-7) and depression (Patient Health Questionnaire-9: PHQ-9) were used. The relation between Axis I and Axis II was examined.A significantly larger number of women had subjective symptoms and tenderness points compared to men, but there was no gender difference in the other variables. There was a significant strong correlation (r = 0.745) between GAD-7 and PHQ-9, and a significant weak correlation (r = 0.322) between OBC and the number of tenderness points. The P group had a significantly higher number of tenderness points and PHQ-9 value compared to the N group. Significant odds ratio was found in the number of tenderness point, slight depression level judged by using PHQ-9, and positive answer in 5th question item of OBC as an independent variable with the presence of subjective symptom as a dependent variable.These results suggest that there is a correlation between Axis I and Axis II diagnoses of DC/TMD in studies using dental students without or with slight symptoms of TMD. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were determined by clinical examination (Axis I) and psychosocial examination (Axis II), but the relation between Axis I and Axis II has not been investigated. The purpose of this study was to clarify the correlation between Axis I and Axis II with a cross-sectional survey.The subjects were 226 students in the fifth grade of Nihon University School of Dentistry at Matsudo (144 males and 82 females, mean age 23.8±2.7). To make a diagnosis for DC/TMD Axis I, subjective symptoms (Yes: Patient (P) group or No: Normal (N) group) on the examination form and the number of tenderness points on palpation were used. As for Axis II, Oral Behavior Checklist (OBC), anxiety (Generalized Anxiety Disorder-7: GAD-7) and depression (Patient Health Questionnaire-9: PHQ-9) were used. The relation between Axis I and Axis II was examined.A significantly larger number of women had subjective symptoms and tenderness points compared to men, but there was no gender difference in the other variables. There was a significant strong correlation (r = 0.745) between GAD-7 and PHQ-9, and a significant weak correlation (r = 0.322) between OBC and the number of tenderness points. The P group had a significantly higher number of tenderness points and PHQ-9 value compared to the N group. Significant odds ratio was found in the number of tenderness point, slight depression level judged by using PHQ-9, and positive answer in 5th question item of OBC as an independent variable with the presence of subjective symptom as a dependent variable.These results suggest that there is a correlation between Axis I and Axis II diagnoses of DC/TMD in studies using dental students without or with slight symptoms of TMD. DC/TMDによる顎関節症の診断は身体的評価（Ⅰ軸）および心理社会的評価（Ⅱ軸）の2軸により行われるが，Ⅰ軸とⅡ軸間の相関についての検討がなされていない。本研究はDC/TMDにおける2軸診断の関連性を検討することを目的としてスクリーニング調査を行った。被験者は日本大学松戸歯学部の5年次生226名（男性144名，女性82名，平均年齢23.8±2.7歳）とした。DC/TMDのⅠ軸診断にはExamination Formにおける症状に対する自覚の有無（自覚ありをP群，なしをN群），圧痛検査における圧痛部位数を用い，Ⅱ軸診断はOBC（口腔行動），GAD-7（不安傾向），PHQ-9（抑うつ傾向）を用いて両者の関係性を検討した。症状の自覚，圧痛部位数は女性が有意に多かったが，他の項目には男女差は認めなかった。GAD-7とPHQ-9の間にr=0.745の有意な強い相関関係を認め，OBCと圧痛部位数の間にr=0.322の有意な弱い相関関係を認めた。P群ではN群に比べ圧痛部位数とPHQ-9の値が有意に高かった。自覚症状の有無を従属変数として，独立変数の圧痛部位数，PHQ-9軽度，OBCの5番目の質問項目のオッズ比に有意な値を認めた。以上より，顎関節症症状を認めない，もしくは軽度の学生を対象としてDC/TMDにおけるⅠ軸診断とⅡ軸診断を検討した結果，両者の間に関連性が確認された。 |
| Author | UCHIDA, Takashi MURAMORI, Juri KOMIYAMA, Osamu IIDA, Takashi OKAMOTO, Yasuhiro WAKAMI, Masanobu |
| Author_FL | 岡本 康裕 若見 昌信 内田 貴之 飯田 崇 村守 樹理 小見山 道 |
| Author_FL_xml | – sequence: 1 fullname: 内田 貴之 – sequence: 2 fullname: 小見山 道 – sequence: 3 fullname: 飯田 崇 – sequence: 4 fullname: 岡本 康裕 – sequence: 5 fullname: 村守 樹理 – sequence: 6 fullname: 若見 昌信 |
| Author_xml | – sequence: 1 fullname: OKAMOTO, Yasuhiro organization: Nihon University Department of Oral Diagnostics, School of Dentistry at Matsudo – sequence: 1 fullname: UCHIDA, Takashi organization: Nihon University Department of Oral Diagnostics, School of Dentistry at Matsudo – sequence: 1 fullname: WAKAMI, Masanobu organization: Nihon University Department of Oral Health Science, Division of Oral Function and Rehabilitation, School of Dentistry at Matsudo – sequence: 1 fullname: KOMIYAMA, Osamu organization: Nihon University Department of Oral Health Science, Division of Oral Function and Rehabilitation, School of Dentistry at Matsudo – sequence: 1 fullname: IIDA, Takashi organization: Nihon University Department of Oral Health Science, Division of Oral Function and Rehabilitation, School of Dentistry at Matsudo – sequence: 1 fullname: MURAMORI, Juri organization: Nihon University Department of Pathology, School of Dentistry at Matsudo |
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| Copyright | 2019 Japanese Society for Temporomandibular Joint |
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| DocumentTitle_FL | DC/TMDにおけるⅠ軸，Ⅱ軸診断の関連性の研究 |
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| References_xml | – reference: 12) 和気裕之, 澁谷智明. 顎関節症患者の見方と対応-特に心身医学の側面から-. Compr Med 2016; 15: 32-41. – reference: 22) Chisnoiu AM, Picos AM, Popa S, Chisnoiu PD, Lascu L, Picos A, et al. Factors involved in the etiology of temporomandibular disorders-a literature review. Clujul Med 2015; 88: 473-8. – reference: 14) 和気裕之. 顎関節症患者の不安と抑うつに関する心身医学的研究. 口科誌 1999; 48: 377-90. – reference: 32) Dao TT, LeResche L. Gender differences in pain. J Orofac Pain 2000; 14: 169-84. – reference: 4) Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992; 6: 301-55. – reference: 29) 岡本康裕, 内田貴之, 多田充裕, 青木伸一郎, 遠藤弘康, 大沢聖子, 他. 中年期以降の顎関節症患者における喪失歯数の検討. 日大口腔科学 2016; 42: 18-24. – reference: 10) 宮地英雄. いわゆる2軸の評価とDSM-5. 日顎誌 2015; 27: 196-9. – reference: 31) Mikkelsson M, Salminen JJ, Sourander A, Kautiainen H. Contributing factors to the persistence of musculoskeletal pain in preadolescents: a prospective 1-year follow-up study. Pain 1998; 77: 67-72. – reference: 20) 田中 裕, 村松芳幸, 瀬尾憲司. Patient Health Questionnaire (PHQ-9) を用いた口腔顔面痛患者の心身医学的検証. 慢性疼痛 2015; 34: 69-74. – reference: 13) 松岡紘史, 安彦善裕, 豊福 明, 森谷 満, 坂野雄二, 千葉逸朗, 他. PHQ-9およびGAD-7を使用した歯科医師のうつ病に関する知識についての調査. 日歯心身 2015; 30: 55-62. – reference: 26) 河村篤志, 高嶋真樹子, 荒井良明, 髙木律男. RDC/TMDを用いたTMD患者の身体症状および心理社会的障害の特徴. 日顎誌 2015; 27: 200-6. – reference: 25) 塚越 香, 西山 暁, 木野孔司, 杉崎正志, 羽毛田匡. 顎関節症の疼痛症状に影響を与える因子. 日口腔顔面痛会誌 2011; 4: 47-55. – reference: 7) Ohrbach R, Dworkin SF. The evolution of TMD diagnosis: Past, present, future. J Dent Res 2016; 95: 1093-101. – reference: 1) 有馬太郎. DC/TMD (Diagnostic Criteria for Temporomandibular Disorders) をマスターするための手順. 日顎誌 2015; 27: 87-92. – reference: 8) Takayama Y, Miura E, Miura K, Ono S, Ohkubo C. Condition of depressive symptoms among Japanese dental students. Odontology 2011; 99: 179-87. – reference: 15) de Leeuw JR, Ros WJ, Steenks MH, Lobbezoo-Scholte AM, Bosman F, Winnubst JA. Multidimensional evaluation of craniomandibular dysfunction. II: Pain assessment. J Oral Rehabil 1994; 21: 515-32. – reference: 18) Dworkin SF, Huggins KH, Wilson L, Mancl L, Turner J, Massoth D, et al. A randomized clinical trial using research diagnostic criteria for temporomandibular disorders-axis II to target clinic cases for a tailored self-care TMD treatment program. J Orofac Pain 2002; 16: 48-63. – reference: 24) 森岡範之, 田邊憲昌, 藤澤政紀. 心理テストを用いた顎関節症発症に関する5年間の前向きコホート研究. 日歯心身 2007; 22: 3-9. – reference: 6) De La Torre Canales G, Câmara-Souza MB, Muñoz Lora VRM, Guarda-Nardini L, Conti PCR, Rodrigues Garcia RM, et al. Prevalence of psychosocial impairment in temporomandibular disorder patients: A systematic review. J Oral Rehabil 2018; 45: 881-9. – reference: 19) 井辺弘樹, 木村晃久. ストレスによる下行性疼痛調整系の機能変化. J Musculoskelet Pain Res 2015; 7: 7-14. – reference: 2) 石垣尚一. DC/TMDにおけるAxisⅡの概念とその利用法. 日顎誌 2018; 30: 168-76. – reference: 9) Markiewicz MR, Ohrbach R, McCall WD Jr. Oral behaviors checklist: Reliability of perfomance in targeted waking-state behaviors. J Orofac Pain 2006; 20: 306-16. – reference: 28) 馬場一美, 小野康寛, 西山 暁. 顎機能障害の診断と発症原因を考慮に入れた治療 パラファンクションと顎機能障害の発症. 日補綴会誌 2009; 1: 7-12. – reference: 16) Reiter S, Emodi-Perlman A, Goldsmith C, Friedman-Rubin P, Winocur E. Comorbidity between depression and anxiety in patients with temporomandibular disorders according to the research diagnostic criteria for temporomandibular disorders. J Oral Facial Pain Headache 2015; 29: 135-43. – reference: 23) McCreary CP, Clark GT, Merril RL, Flack V, Oakley ME. Psychological distress and diagnostic subgroups of temporomandibular disorder patients. Pain 1991; 44: 29-34. – reference: 27) Sato F, Kino K, Sugisaki M, Haketa T, Amemori Y, Ishikawa T, et al. Teeth contacting habit as a contributing factor to chronic pain in patients with temporomandibular disorders. J Med Dent Sci 2006; 53: 103-9. – reference: 11) 和気裕之, 小見山道. 顎関節症患者の心身医学的な治療の変遷. 日補綴会誌 2012; 4: 256-66. – reference: 30) Komiyama O, Obara R, Iida T, Nishimura H, Okubo M, Uchida T, et al. Age-related associations between psychological characteristics and pain intensity among Japanese patients with temporomandibular disorder. J Oral Sci 2014; 56: 221-5. – reference: 17) 田中 裕, 村松芳幸, 真島一郎, 片桐敦子, 藤村健夫, 清水夏恵, 他. 口腔顔面領域の慢性疼痛患者に対する初診時の心理的因子の検討. 心身医学 2010; 50: 1187-96. – reference: 3) Manfredini D, Marini M, Pavan C, Pavan L, Guarda-Nardini L. Psychosocial profiles of painful TMD patients. J Oral Rehabil 2009; 36: 193-8. – reference: 5) Manfredini D, Ahlberg J, Winocur E, Guarda-Nardini L, Lobbezoo F. Correlation of RDC/TMD axis I diagnoses and axis II pain-related disability. A multicenter study. Clin Oral Investig 2011; 15: 749-56. – reference: 21) Velly AM, Gornitsky M, Philippe P. Contributing factors to chronic myofascial pain: a case-control study. Pain 2003; 104: 491-9. |
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| Title | A study on the relationship between Axis I and Axis II diagnoses of DC/TMD: A cross-sectional survey of dental students |
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