title: Profiling the clinical presentation of diagnostic characteristics of a sample of symptomatic TMD patients.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil.
authors.forename: Luciana
authors.initials: L
authors.lastname: Pimenta e Silva Machado
authors.forename: Marianita Batista
authors.initials: MB
authors.lastname: de Macedo Nery
authors.forename: Cláudio
authors.initials: C
authors.lastname: de Góis Nery
authors.forename: Cláudio Rodrigues
authors.initials: CR
authors.lastname: Leles
mesh_terms: D059787:Acute Pain / Q000145:classification / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000145:classification / Q000503:physiopathology; D002012:Bruxism / Q000145:classification / Q000503:physiopathology; D002648:Child; D059350:Chronic Pain / Q000145:classification / Q000503:physiopathology; D016000:Cluster Analysis; D003953:Diagnosis-Related Groups / Q000145:classification; D005157:Facial Pain / Q000145:classification / Q000503:physiopathology; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000145:classification / Q000503:physiopathology; D008297:Male; D008410:Masticatory Muscles / Q000503:physiopathology; D008875:Middle Aged; D010003:Osteoarthritis / Q000145:classification / Q000503:physiopathology; D010147:Pain Measurement; D010347:Patient Care Planning; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D013585:Synovitis / Q000145:classification / Q000503:physiopathology; D019224:Temporomandibular Joint Disc / Q000503:physiopathology; D013705:Temporomandibular Joint Disorders / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D055815:Young Adult