心理因素与颞下颌关节紊乱病症状表现的相关性研究

目的:探讨焦虑和抑郁是否为罹患颞下颌关节紊乱病(TMD)的危险因素。方法:病例组为临床TMD患者,对照组为无TMD症状的健康人,采用焦虑症状自评量表(SAS)和抑郁症状自评量表(SDS)对心理因素进行评估。同时记录是否存在其他混杂因素,如习惯咬硬物、偏侧咀嚼、叩齿、夜磨牙、拔牙史等。采用Stata 11.0软件包对数据进行统计学分析。结果:共纳入200例样本,每组各100例,病例组SAS评分、SDS评分均显著高于对照组(P<0.05)。对不同严重程度焦虑倾向、抑郁倾向的OR进行趋势检验,均具有统计学意义。但logistic回归分析显示,患颞下颌关节紊乱病的危险因素中,仅焦虑倾向与偏侧咀嚼具有统计学意义(P<0.05)。结论:焦虑倾向与抑郁倾向为TMD相关的重要危险因素,随着其严重程度的增加,患TMD的危险性也增加。在混杂因素偏侧咀嚼存在时,只有焦虑倾向仍然是TMD的危险因素。     

润滑功能与颞下颌关节紊乱病

颞下颌关节是具有复杂运动的联动关节，其长期的健康状态与润滑功能密不可分。其有关的润滑机理包括滑液、关节盘和关节软骨等方面。关节内自由基过多可以导致润滑功能障碍，颞下颌关节紊乱病与润滑功能障碍密切相关。     

颞下颌关节紊乱病诊断标准的研究进展

颞下颌关节紊乱病(temporomandibular disorders,TMDs)是临床常见病但是病因复杂,相应的颞下颌关节紊乱病的诊断标准也在不停演变.本文围绕由RDC/TMD到DC/TMD的改进,DC/TMD的临床应用实施进行综述,并对未来可能的发展进行展望.     

颞下颌关节紊乱病与系统性疾病相关性研究进展

颞下颌关节紊乱病是口腔颌面部常见的疾病之一,颞下颌关节紊乱病并非指单一疾病,它是一类病因尚未完全清楚而又有相同或相似临床症状的一组疾病的总称。颞下颌关节紊乱病的发病机制尚未完全阐明,多数学者解释为多种致病因素相互作用下发生。近年来研究发现糖尿病、类风湿性关节炎、系统性红斑狼疮、强直性脊柱炎等全身系统性疾病与颞下颌关节紊乱病的发生相关,本文对颞下颌关节紊乱病与部分系统性疾病相关性研究进展进行阐述。     

颞下颌关节紊乱病的治疗

关于因素是否颢下颌关节紊乱病(TMD)病因之一,以及TMD的治疗,现存在着各种争议.本文回顾了有关研究及观点.目前,无论是动物实验研究,还是临床实验研究,都不足以作出因素是TMD病因之一的结论.但是, 治疗在TMD临床治疗中占有重要地位,且发挥重要作用:调能有效地缓解慢性头痛,颈痛及肩部痛; 治疗对减轻TMD患者的肌肉疼痛也显示理想效果;调位咬合板能消除一部分关节弹响.进一步探索TMD的因素,正确掌握TMD 治疗的适应证及客观科学地评价治疗的临床效果是我们今后研究的课题.     

468例颞下颌关节紊乱病的诊治分析

颞下颌关节紊乱病(temporomandibular disorders，TMD)是一种常见病、多发病。由于颞下颌关节结构较复杂，口颌系统功能又多种多样，往往患病后造成患者生活与精神上的苦恼。本文对10年来诊治的468例TMD患者进行分析。     

颞下颌关节紊乱病症状、体征与患者生活质量的关系

目的定量分析颞下颌关节紊乱病（temporomandibulardisorders,TMD）症状、体征与患者生活质量的关系。方法连续选择初次就诊的TMD患者492例,自制“生活质量视觉模拟尺评估表”,计分评价TMD患者生活质量受影响程度。结果TMD对生活质量的影响主要表现在咀嚼、日常生活和情绪方面;单纯关节弹响对生活质量的影响最小;关节绞锁对生活质量的影响显著大于单纯关节弹响;重度和中度的疼痛、开口受限对生活质量的影响显著大于轻度的疼痛、开口受限。结论临床治疗应考虑TMD患者主诉症状对生活质量的影响程度。     

Activator矫治对颞下颌关节的影响及其与颞下颌关节紊乱病的关系

Activator矫治器是较早用于临床的功能矫治器,由Andresen于1908年设计,对安氏Ⅱ类1分类错(牙合)畸形患者有良好的治疗效果,通过前移下颌刺激下颌骨的生长且抑制上颌矢状向生长,从而调节上下颌骨矢状向的关系.目前,关于Activator矫治器的矫治原理还存在较多的分歧,其中之一就有Activator是否能刺...     

Spee曲线与颞下颌关节紊乱病的相关性

牙合因素在颞下颌关节紊乱病（temporomandibular disorders,TMD）的病因和病理中占有重要地位。Spee曲线是评价牙合这一生物力学三维结构中垂直向位置关系的关键指标,该曲线与TMD相关性的研究与分析一直是口腔医学中常做常新的课题。本文从Spee曲线的基本功能、形态特点以及各类影响因素等方面,对该曲线与TMD的相关性研究现状进行综述,并提出相关展望。     

颞下颌关节紊乱病的心理因素的研究

目的：探讨心理因素在颞下颌关节紊乱病(TMD)发病机制中的作用。方法：采用焦虑自评量表(SAS)、抑郁自评量表(SDS)和明尼苏达多项人格量表(MMPI)对颞下颌关节紊乱病患组和正常对照组各30例进行调查。结果：TMD患组与对照组相比，具有较高的焦虑和抑郁得分；MMPI测试结果显示，在MMPI十项临床量表中，患组在其中的疑病(HS)、抑郁(D)、癔病(HY)、精神病态(PD)、精神衰弱(PT)、精神分裂(SC)、社会内-外向(SI)七项中得分均高于对照组。另外，患组有26例临床量表中的一项或多项得分高于常模分数，说明TMD患的人格有偏离现象。结论：颞下颌关节紊乱病患的情绪障碍以及人格特征在其发病机制中具有重要作用。     

颞下颌关节紊乱病患者唾液中氧化应激状态与焦虑抑郁情绪的关系

目的：探讨颞下颌关节紊乱病（TMD）患者唾液中氧化应激（OS）状态与焦虑抑郁情绪之间的相关关系。方法：应用医院焦虑抑郁量表（HAD）对30名TMD患者的焦虑抑郁情绪进行评估并将其分为焦虑抑郁组（A组）和非焦虑抑郁组（B组）,10名正常人作为对照（C组）。采用TBA法和ELISA试剂盒分别对受试者唾液中丙二醛（MDA）和8-羟基脱氧鸟苷（8-OHdG）含量进行测定。结果：A组HAD评分高于B组,两组间比较差异有统计学意义。A组MDA和8-OHdG水平明显高于B组及C组,差异具有统计学意义。Pearson相关分析显示MDA和8-OHdG均与焦虑抑郁得分呈明显正相关。结论：TMD患者存在氧化损伤,伴焦虑抑郁情绪的患者抗氧化酶防御能力进一步减弱,提示氧化应激指标可能与TMD症状的发生和发展密切相关。警示临床重视早期TMD患者,预防进展到重度疼痛和功能紊乱。     

磨牙症与颞下颌关节紊乱病关系的研究

磨牙症和颞下颌关节紊乱病都是口腔临床上的常见病，均病因不明，诊治困难。多年来学者们试图研究两者的内在联系和机制，但至今观点仍不统一。本文就磨牙症与颞下颌关节紊乱病的关系以及磨牙症引起颞下颌关节紊乱病的可能机制的研究进展作一综述。     

A Preliminary Protocol for Multi-Professional Centers for the Determination of Signs and Symptoms of Temporomandibular Disorders

Abstract

The objective of the present study was to test a protocol for the quantification of the frequency and severity of signs and symptoms of temporomandibular disorders (TMD) according to patient perception during two phases of investigation. The protocol was developed based on the signs and symptoms most frequently reported in the literature and on the circumstances in which they produce discomfort. Eighty-four patients diagnosed with TMD by functional examination of the masticatory system responded to the protocol questions and indicated the severity of signs and symptoms using an eleven point numerical scale (Phase 1). Forty-two patients were fitted with an occlusal splint (treated group) and the remaining participants did not use a splint (control group). The protocol questions were asked after 50 days of treatment (Phase 2). Based on the results of nonparametric statistical analysis, the incidence of signs and symptoms was high in Phase 1 and significant, with no difference between the groups, whereas the treated and control groups differed in Phase 2. A comparison between Phases 1 and 2 showed that only the treated group presented a reduction in the severity of signs and symptoms. The study showed that using this protocol, it is possible to define the frequency and severity of symptoms as well as the effect of the treatment. The advantage of this protocol is that it would complement the data obtained using clinical examination with information provided by the patient in a measurable manner.     

Malocclusions and Clinical Signs or Subjective Symptoms of Temporomandibular Disorders (TMD) in Adults

AIM AND METHOD: The objective was to determine with reference to a representative sample of 4310 men and women aged 20 to 81 (response rate 68.8%) drawn from the population-based Study of Health in Pomerania (SHIP-0) whether associations exist between malocclusions and temporomandibular dysfunctions in adults. Besides clinically investigated signs, subjectively perceived symptoms of temporomandibular disorders (TMD) were studied in each individual together with malocclusions (plus normal occlusion), functional occlusion factors, and sociodemographic parameters. A multivariate logistic regression analysis was used, adjusted for age and discriminated for gender. The results were compared with those of other population-based studies identified by a systematic review undertaken by the present authors. RESULTS: Some malocclusions were associated with signs or symptoms of TMD but tended to occur only rarely: unilateral open bite, negative overjet, and unilateral scissors-bite in men, and edge-to-edge bite in women. However, malocclusions (and functional occlusion factors) accounted for only a small part of the differences between the control population and the study population with signs or symptoms of TMD. In terms of the multifactorial problem of temporomandibular disorders they should be seen as cofactors. The results, together with those of other population-based studies, revealed no specific, i.e. recurring malocclusions (or other occlusal factors) presenting as risk markers.     

青少年心理行为与牙科焦虑症的相关性研究

目的：调查研究口腔门诊青少年患者心理行为与牙科焦虑症（DA）的相关性。方法：利用改良牙科焦虑量表以及自制青少年心理行为问卷表对400例口腔门诊青少年患者进行问卷调查,对被调查者性别、是否有牙科治疗史以及3种不同的心理行为分组进行分析。结果：回收有效问卷379份,有效率94．75％;不同性别和对DA的发生差异极有统计学意义（P〈0．01）,Pearson列联系数r=0．27;是否有既往口腔科治疗史对DA的发生差异有统计学意义（P〈0．05）,r=0．11;紧张与焦虑行为和自我控制力行为与DA有关（P％0．05）,r分别为0．55和0．35;而内向和羞怯行为与DA无明显关联。结论：DA在青少年患者中常见,性别、既往口腔科科治疗史以及部分心理行为对DA有影响．     

Correlation of Occlusal Factors and Condyle Position Asymmetry with Signs and Symptoms of Temporomandibular Disorders in Young Adults

The role of the occlusion in the etiology and prevalence of temporomandibular disorders (TMD) has not been conclusively demonstrated. Occlusal factors and condyle position asymmetry as deduced from computed tomography (CT) axial scans were correlated with signs and symptoms of TMD in 49 young adults (mean age 24 years, range 15–33 years) with complete or almost complete dentition. A statistically significant correlation was noted between these signs and symptoms and occlusal variables describing asymmetry (the amount and lateral deviation of the slide from the retruded contact position (RCP) to the intercuspal position (IP), deviation of protrusion and asymmetry in bilateral cuspid occlusion). It seems that occlusal discrepancy can be a predisposing factor to TMD, especially when it is asymmetrically expressed.     

成人颞下颌关节紊乱病与颈椎姿势的相关性研究

目的：探讨颞下颌关节紊乱病成人患者颈椎姿势与健康者的差异,研究颞下颌关节紊乱病与颈椎姿势的相关性。方法：对20例成人颞下颌关节紊乱病患者及20例成人健康者拍摄自然头位时的头颅定位侧位片,进行投影测量及统计学分析。结果：成人颞下颌关节紊乱病组的颈椎弯曲度大于健康对照组而颈椎倾斜度小于健康对照组,颈椎齿突切线、颈椎切线分别与前颅底平面及水平线交角减小,表明成人颞下颌关节紊乱病患者头呈前倾、前伸位。结论：头颈姿势位与颞下颌关节紊乱病存在明显相关性,颞下颌关节紊乱病患者头呈前倾、前伸位。