title: Temporomandibular Disorder Diagnostic Groups Affect Outcomes Independently of Treatment in Patients at Risk for Developing Chronicity: A 2-Year Follow-Up Study.
abstract: OBJECTIVE
  To evaluate whether a biobehavioral intervention would be more effective than a self-care intervention or no intervention in reducing psychosocial distress, reducing pain, and improving functioning in patients with an acute myofascial temporomandibular disorder (m-TMD).
  
  
  METHODS
  Participants (n = 435) were from community dental clinics in the Dallas-Fort Worth Metroplex who were seeking treatment for their acute TMD symptoms and were recruited between 2008 and 2013. The participants were diagnosed using the Research Diagnostic Criteria for TMD (RDC/TMD) and assigned to a biobehavioral intervention, self-care intervention, or no intervention. Three outcomes were assessed: psychosocial distress, pain, and functioning; and treatment effectiveness was assessed according to TMD diagnosis. Outcome evaluations were conducted immediately postintervention as well as at 1 and 2 years postintervention. Analyses were conducted using two-level hierarchical multilevel linear models (MLMs).
  
  
  RESULTS
  Contrary to expectations, patients did not respond differently to the intervention based on their TMD diagnosis. Acute m-TMD patients, especially those with other comorbid TMD diagnoses, reported the highest levels of pain and pain-related symptoms and disability. They also exhibited poorer jaw functioning, especially if they were at high risk for chronic TMD.
  
  
  CONCLUSIONS
  This study indicates that acute m-TMD tends to result in more severe symptom presentations, particularly if diagnosed in combination with other TMD comorbidities. Additionally, patients do not appear to respond better to biobehavioral or self-care intervention on the basis of their TMD diagnosis.
authors.forename: Celeste
authors.initials: C
authors.lastname: Sanders
authors.forename: Angela
authors.initials: A
authors.lastname: Liegey-Dougall
authors.forename: Rob
authors.initials: R
authors.lastname: Haggard
authors.forename: Peter
authors.initials: P
authors.lastname: Buschang
authors.forename: Steve
authors.initials: S
authors.lastname: Karbowski
authors.forename: Richard
authors.initials: R
authors.lastname: Riggs
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Gatchel
mesh_terms: D000208:Acute Disease; D000328:Adult; D000066949:Biobehavioral Sciences; D002908:Chronic Disease; D003863:Depression / Q000175:diagnosis; D005157:Facial Pain / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis; D008297:Male; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis; D010147:Pain Measurement / Q000379:methods; D011788:Quality of Life; D012307:Risk Factors; D012648:Self Care; D013001:Somatoform Disorders / Q000175:diagnosis; D013315:Stress, Psychological / Q000175:diagnosis; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome