Clinical Application Of A Digital Questionnaire Based On RDC/TMD

Objective:Temporomandibular disorders (TMD) is a kind of commonly and frequently-occurring disease in dental clinical. The clinical signs of TMD is various. Among them, pains in maxillofacial region; murmurs in Temporomandibular jiont(TMJ); motion abnormalities in mandible; headache; ear disease are very common. It is a long course, the pain is severe and it is repeatedly attacked. Patients feel more pain. The theories dealing with the aetiology are complex. The occlusal factors, psychological factors, immunological factors and so on are common. The present studies are focused on clarify the pathogenetic mechanisms of the TMD, and more and more scholars have acknowledged psychological factors play a very important role in the aetiology and treatment of TMD. Some scholars view psychological factors as primary factors. The research diagnostic criteria for temporomandibular disorders (RDC/TMD) is used to provide a clinical standardization diagnosis. This RDC/TMD is an overall assessment which is divided into two axes, axis I (clinical TMD) and axisⅡ. (pain-related, disability and psychological status). At present, as the development and improvement of the computer, the application is used more widely and the technology which uses software to diagnosis will be more sophisticated. We compile a program which combine digital questionnaire with computer-based patient record. The TMD digital questionnaire is used to access the depression symptom scale (DSS), the pain intensity (PI) and the limitation related to mandibular functioning (LRMF).Methods:We use Microsoft Office Access 2007 as background database, use Borland Delphi 7.0 as development tools, use the interface, ADO, which is connected with database, and RDC/TMD is used as a clinical standardization diagnosis to establish the digital questionnaire. The digital questionnaire contains twenty-eight questions. Questions seven to thirteen are used to evaluate pain intensity (PI). Questions twenty are used to evaluate depression symptom score (DSS). Questions nineteen are used to evaluate limitation related to mandibular functioning (LRMF). When patients are in first, they are asked to answer The RDC/TMD digital questionnaire. Data collect:we select the patients who are above eighteen, can cooperate with inspection, understand the digital questionnaire attendant in the Tianjin Medical University TMD outpatient service and are diagnosed as TMD patients based on RDC/TMD axis I. The mean age of them was 31.14±13.79(range 18～71) with a sex distribution of 21 females and 15 males. We input, filter, and analysis the data we collected, and we use statistical correlation analysis method of evaluation to evaluate these patients'DSS, PI and LRMF.Results:1. The three most frequent jaw disabilities were:eating hard foods (88.9%), chewing (83.3%) and yawning (80.6%). More than 50%of the sample population had these three jaw disabilities.2. Most patients (97.2%) had low disability, with 10 patients having low PI (Grade I) and 25 patients having moderately PI (GradeⅡ).3. The study demonstrated that PI significantly related to DSS (r=0.531, P<0.05), PI is low-grade related to LRMF (r=0.387, P＜0.05) in Grade I4. The study demonstrated statistically significant differences in the DSS and the PI (r=0.606, P＜0.05), PI is low-graderelated to LRMF (r=0.318, P<0.05),DSS is low-graderelated to LRMF (r=0.324, P<0.05)in GradeⅡ.Conclusion:The patients who are severely depressed have higher PI than normal patients. Patients that are moderately or severely depressed have significantly higher scores for the LRMF than normal patients. The TMD digital questionnaire is working well and acting as an assistant diagnosis in TMD. So the treatment of it, in adittion to the traditional physical therapy and surgical treatment, should pay more attention to correct undesirable mood of the patients. Our digital questionnaire oprate well and help TMD diagnosis,standard TMD diagnosis, and with the superiority of the computer:(1) Interface convenient and is operated friendly; (2) Built-in module can give the doctor a guidline; (3) patients can avoid some privacy that they do not want to answer. The system run smoothly. Users reflect it accord with their using habits. The digital questionnaire grately improve clinical and scientific research and it makes work quality and efficiency.