成人正畸治疗对颞下颌关节的影响及其与颞下颌关节紊乱病的关系

目的探讨成人正畸治疗对颞颌关节（temporomandibular joint，TMJ）的影响及其与颞下颌关节紊乱病（temporomandibular disorderTMD）的关系。方法选择60名20～29岁成人正畸患者，用Helkimo指数将患者分为TMJ无症状组、TMJ有症状组两组，分别在治疗前（t1）、治疗中期（t2）及治疗结束后（t3），用MRI检查治疗前后关节盘的位置，并用电子测量尺测量TMJ的前、后间隙，观察颞颌关节在治疗前后的变化情况与TMD之间的关系。结果TMJ无症状组、TMJ有症状组在治疗中TMD的发生率分别为18．20％、56．25％，差异有显著性（P〈0．05），并发现关节盘移位，治疗后关节前间隙增加，关节后间隙减少。结论成人正畸治疗不会导致TMD，但在治疗过程中可能出现TMD症状，并有出现TMD重度症状的风险。成人在正畸治疗前对TMJ进行评估有重要意义。

Correlations Between Temporomandibular Disorder and Adult Patients During Orthodontic Treatment

Objective To investigate the correlations between temporomandibular disorder and adult patients receiving orthodontic treatment. Methods Sixteen adults with maloeelusions aged from 20 to 29 years old were divided into two groups according to Helkimo index. Group AiO included 44 patients. Group AiI included 16 patients. Before and after orthodontic treatment, temporomandibular joint disc positions were measured in MRI images. The function of TMJ was evaluated by Helkimo index. Results The incidence of TMD in Group AiI （56.25%） was much higher than Group AiO （ 18.20% ） , （ P 〈0. 05 ）. The anterior displacements of the temporomandibular joint disc were found. After orthodontic treatment,anterior space area of TMJ was increased and posterior space area was reduced. Conclusion Orthodontic treatment does not cause TMD, but it may induce and aggravate the symptoms of TMJ.