Вплив оклюзійної дисфункції на якість життя пацієнтів із скронево-нижньощелепними розладами: роль болю та тривоги

Olena Doroshenko; Iaroslav Ostrovskyi

doi:10.33295/1992-576X-2026-3-PSDN-2

Authors

Olena Doroshenko P. L. Shupyk National University of Health of Ukraine, Kyiv, Ukraine
Iaroslav Ostrovskyi P. L. Shupyk National University of Health of Ukraine, Kyiv, Ukraine

DOI:

https://doi.org/10.33295/1992-576X-2026-3-PSDN-2

Keywords:

temporomandibular disorders, occlusal dysfunction, oral health-related quality of life, chronic pain, anxiety, mediation analysis

Abstract

Aim — to determine the direct and indirect pathways of the influence of occlusal disorganization (according to the FPDI index) on oral health-related quality of life in patients with temporomandibular disorders (TMD), and to evaluate the mediating role of pain and psychoemotional disorders.

Materials and Methods. A cross-sectional study was conducted involving 125 patients with verified TMD (according to DC/TMD Axis I) and 31 healthy controls. The mean age of the patients was 47.6±8.5 years, and 69.9% were women. The Functional Passivity / Parameter / Functional Disorganization Index (FPDI), pain intensity using a visual analog scale (VAS), levels of anxiety (HADS-A) and depression (HADS-D), as well as oral health-related quality of life using the OHIP-14 questionnaire, were assessed. To test mediation hypotheses, the Preacher & Hayes method was used with bootstrapping (5,000 resamples) to calculate indirect effects and 95% confidence intervals (95% CI).

Results. The total effect of FPDI on OHIP-14 was β = 0.68 (p < 0.001). After including mediators, the direct effect decreased to β = 0.29 (p < 0,05), which confirmed partial mediation: indirect effects explained 57.4% of the total effect. The strongest indirect pathway was FPDI → pain (VAS) → OHIP-14 (β = 0.32; 95% CI 0.19–0.45), which accounted for 47.1% of the total effect. The pathway through anxiety (FPDI → HADS-A → OHIP-14) had a moderate indirect effect (β = 0.12; 95% CI 0.05–0.20; 17.6%), while the pathway through depression was found to be statistically non-significant (β = 0.04; 95% CI –0.02–0.11). The overall model explained 62.4% of the OHIP-14 variance (R ² = 0.624).

Conclusions. The influence of occlusal disorganization on the reduction in oral health-related quality of life in patients with TMD is realized predominantly indirectly—through chronic pain, which accounts for almost half of the total effect. The obtained results justify the need for simultaneous correction of occlusal disorders, pain, and anxiety within the framework of comprehensive prosthodontic rehabilitation to achieve a statistically and clinically significant improvement in patients’ quality of life.

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Author Biographies

Olena Doroshenko, P. L. Shupyk National University of Health of Ukraine, Kyiv, Ukraine

ORCID: https://orcid.org/0000-0001-8859-3610

Doctor of Medical Sciences, Professor, Professor of the Department of Orthopedic Dentistry, Digital Technologies and Implantology, P. L. Shupyk National University of Health Care, Kyiv, Ukraine

Iaroslav Ostrovskyi, P. L. Shupyk National University of Health of Ukraine, Kyiv, Ukraine

ORCID: https://orcid.org/0009-0006-9169-0343

Postgraduate student of the Department of Orthopedic Dentistry, Digital Technologies and Implantology, P. L. Shupyk National University of Health Care, Kyiv, Ukraine

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