Profiling the clinical presentation of diagnostic characteristics of a sample of symptomatic TMD patients
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Data
2012
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Resumo
Background: Temporomandibular disorder (TMD) patients might present a number of concurrent clinical
diagnoses that may be clustered according to their similarity. Profiling patients’ clinical presentations can be useful
for better understanding the behavior of TMD and for providing appropriate treatment planning. The aim of this
study was to simultaneously classify symptomatic patients diagnosed with a variety of subtypes of TMD into
homogenous groups based on their clinical presentation and occurrence of comorbidities.
Methods: Clinical records of 357 consecutive TMD patients seeking treatment in a private specialized clinic were
included in the study sample. Patients presenting multiple subtypes of TMD diagnosed simultaneously were
categorized according to the AAOP criteria. Descriptive statistics and two-step cluster analysis were used to
characterize the clinical presentation of these patients based on the primary and secondary clinical diagnoses.
Results: The most common diagnoses were localized masticatory muscle pain (n = 125) and disc displacement
without reduction (n = 104). Comorbidity was identified in 288 patients. The automatic selection of an optimal
number of clusters included 100% of cases, generating an initial 6-cluster solution and a final 4-cluster solution. The
interpretation of within-group ranking of the importance of variables in the clustering solutions resulted in the
following characterization of clusters: chronic facial pain (n = 36), acute muscle pain (n = 125), acute articular pain
(n = 75) and chronic articular impairment (n = 121).
Conclusion: Subgroups of acute and chronic TMD patients seeking treatment can be identified using clustering
methods to provide a better understanding of the clinical presentation of TMD when multiple diagnosis are
present. Classifying patients into identifiable symptomatic profiles would help clinicians to estimate how common a
disorder is within a population of TMD patients and understand the probability of certain pattern of clinical
complaints.
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Temporomandibular disorders, Diagnosis-related groups, Cluster analysis, Clinical diagnosis
Citação
MACHADO, Luciana Pimenta e Silva et al. Profiling the clinical presentation of diagnostic characteristics of a sample of satic TMD patients. BMC Oral Health, London, v. 12, n. 26, p. 1-8, 2012.