# Temporomandibular disorder confounders in motor vehicle accident patients

## TL;DR

This study finds that motor vehicle accident patients have more radiographic confounders that can mimic temporomandibular disorder symptoms compared to non-accident patients.

## Contribution

The study identifies specific radiographic confounders more prevalent in MVA patients, aiding in better TMD diagnosis.

## Key findings

- MVA patients had significantly more confounders per patient (1.10) than non-MVA patients (0.68).
- Sinus pathologies and endodontic lesions were the most common confounders in MVA patients.
- The findings suggest the need for comprehensive dental evaluations before TMD specialist referrals.

## Abstract

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.