Temporomandibular disorder confounders in motor vehicle accident patients

Background: Motor vehicle accidents (MVA) are associated with the onset of temporomandibular disorder (TMD) symptoms. However, diagnosing TMD-related pain is challenging due to various entities that can refer pain to the region. This study aims to identify prevalent radiographic confounders to pain diagnosis in MVA patients who were subsequently referred for temporomandibular joint imaging using cone-beam computed tomography (CBCT) by comparing these patients to a cohort of patients without MVA history. Methods: CBCTs of 738 temporomandibular joints were reviewed, with cases stratified by MVA history. This research explored the demographics and calculated the prevalence of radiographic confounders (RC) in each category, comparing the findings for both groups. The chi-square test was used to assess statistical significance. Results: Patients in the MVA cohort (n = 151, mean age = 41.3 years, S.D (Standard Deviation) = 13.3 years) averaged 1.10 confounders/patient compared to a significantly lower 0.68 confounders/patient in the non-MVA cohort (n = 218, mean age = 33.6 years, S.D = 18.2 years). The most frequently identified RCs include sinus pathologies (39.1% (MVA) vs. 28.0% (non-MVA), p = 0.025) and endodontic lesions (22.5% (MVA) vs.10.1% (non-MVA), p = 0.001). Conclusions: Clinicians must be vigilant about confounders when managing patients suspected of TMD. We recommend patients undergo a complete dental evaluation before being referred to a specialist to avoid unnecessary medical costs and treatment delays.

Temporomandibular disorders; Traffic accidents; Motor vehicle accidents; Whiplash injuries; Cone-beam computed tomography; Diagnostic errors; Orofacial pain; Temporomandibular joint

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