咀嚼运动轨迹与颞下颌关节紊乱病患者症状和咬合异常的关系

目的：探讨颞下颌关节紊乱病（TMD）患者的下颌咀嚼运动轨迹特点，及其与症状和咬合异常的关系。方法：23名无症状大学生志愿者和130名TMD患者，取研究模，记录咀嚼运动[牙合]期轨迹。结果：无症状对照组和TMD组咀嚼运动[牙合]期轨迹的形态没有显著差异（P〉0．05）。TMD组矢状面咀嚼运动轨迹的ICP稳定比例明显低于对照组（P〈0．01），但冠状面上咀嚼运动轨迹的ICP稳定比例两组间无明显差异（P〉0．05）。TMD组矢状面[牙合]期轨迹分型与近远中向咬合关系的3级计分存在明显相关关系（P〈0．01），近远中向咬合关系不正常者出现不重合型轨迹的比例较高。疼痛和关节弹响症状与咀嚼运动[牙合]期轨迹形态无关。结论：近远中向咬合关系对咀嚼运动有明显的引导作用。

Correlation between Chewing Movement and Temporomandibular Disorder Patients' Symptoms and Malocclusion

Objective:To investigate the characteristic of chewing movement tracings,and the correlation between the tracings and temporomandibular disorder(TMD) patients' symptoms and malocclusion.Methods: Occlusal casts were obtained from 23 asymptomatic volunteers and 130 TMD patients.And their chewing movement tracings were recorded by mandibular kinesiograph(MKG).The tracings below the tops of chewing movements in 1mm were defined as occlusal phase.Results: Tracings of occlusal phase in asymptom group were not different from TMD group(P>0.05).In sagittal traces,TMD group's instabilities near intercuspal position(ICP) were frequent(P<0.01),but in frontal,the instabilities near ICP were not significantly different in two groups.Abnormal occlusion in mesio-distally direction showed a significant positive correlation with fewer stables in TMD patients' frontal occlusal phase tracings.Pain and sounds in TMD patients were not significant correlated with chewing movement tracings.Conclusion: Mesiodistally direction occlusal relationship obviously piloted chewing movement.