Functional, Physical, and Psychosocial Impact of Degenerative Temporomandibular Joint Disease

Objectives: This study evaluated the functional, physical, and psychosocial impacts of TMJ degenerative joint disease (DJD). The bearing of TMJ osteoarthrosis/osteoarthritis and early/late TMJ DJD on oral health-related quality of life (OHRQoL) were also compared.
Methods: Participants were enrolled from a TMD/orofacial pain centre. Those diagnosed with intra-articular conditions based on the Diagnostic Criteria for Temporomandibular disorders (DC/TMD) were subjected to CBCT assessment and categorized as: NN - no TMJ DJD and no arthralgia; NA - no TMJ DJD with arthralgia; TO - TMJ osteoarthrosis; and TR - TMJ osteoarthritis. The TO/TR groups were subdivided into early/late TMJ osteoarthrosis (EO/LO) and osteoarthritis (ER/LR). OHRQoL was examined using the OHIP-TMD and data was appraised with the Kruskal Wallis/Mann-Whitney U tests (α=0.05).
Results: The study participant (n=400) had a mean age of 32.05±12.71 years (86.8% women). Frequencies of the TMD groups were: NN – 21.3%; NA – 27.3%; TO – 17.8%; and TR – 33.8%. Participants with TR/NA had significantly worse OHRQoL than those with TO/NN. Additionally, participants with ER/LR reported significantly poorer OHRQoL than their counterparts with EO/LO. For all TMD groups and TMJ DJD subgroups, the psychological discomfort domain was the most impaired. Differences in global OHIP scores were significant between participants with and without arthralgia (i.e. NA-NN, ER-EO, and LR-LO).
Conclusions: The presence of TMJ pain appeared to impair OHRQoL more than the severity of TMJ DJD. As psychological domains were most impacted, psychosocial care ought to be incorporated in the management of patients with painful TMJ DJD.