咬合干扰与颞下颌关节紊乱病的相关性研究

目的:通过临床检查分析安氏Ⅱ类1分类颞下颌关节紊乱(temporomandibular disorders,TMD)患者的咬合特点,探讨咬合干扰与颞下颌关节紊乱的相关性。方法:选取安氏Ⅱ类1分类TMD患者60例为实验组,无TMD安氏Ⅱ类1分类患者60例为对照组。采用目前国际上通用的视觉模拟尺分级评分测量法(visual analog scale VAS)对口面部不舒适程度进行评价;按照Fricton指数所包括的内容计算颞下颌功能障碍指数(temporomandibular dysfunction index DI),DI=(MM+JN+JP)/26(0~1)],该指数包括下颌运动(MM)、关节杂音(JN)及关节压诊(JP)等。结果:实验组有咬合干扰者45例,对照组有咬合干扰者42例,二组间差异无显著性(P>0.05);实验组中存在咬合干扰的患者与无咬合干扰患者相比较,DI指数以及疼痛相关视觉模拟分数(VAS)均偏高,二者间差异有统计学意义(P<0.01),其中女性患者DI指数高于男性。结论:咬合干扰(occlusal interferences,OI)与TMD虽无直接联系,但OI与TMD共存可加重TMD患者临床症状,OI的存在对口颌系统的健康可能构成威胁。

Correlational Study on Occlusal Interferences and Temporomandibular Disorders

Objective:To analyze the occlusal features of temporomandibular disorders(TMD)patients with Angle class II division 1 malocclusion,and explore the correlation between occlusal interferences and temporomandibular disorders.Methods:60 Angle class II division1 malocclusion patients with TMD were selected as experimental group,60 Angle class II division1 malocclusion patients without TMD were set as control group.The degree of oral and facial discomfort was evaluated by visual analog scale.Temporomandibular dysfunction index was calculated to compare the symptoms between TMD patients with OI and without OI.Temporomandibular dysfunction index(dysfunction index,DI)includes mandibular movement(mandibular movement,MM),joint noise(joint noise,JN),and joint palpation(joint palpation,JP).Results:There were 45 occlusal interferences patients in experimental group and 42 occlusal interferences patients in control group(P>0.05).In experimental group,the dysfunction index and the visual analog scale score of TMD patients with occlusal interferences was higher than those of TMD patients without occlusal interferences(P<0.01).The dysfunction index of female patients was higher than that of male patients.Conclusion:There was no direct connection between occlusal interferences and TMD,but TMD patients together with occlusal interferences could aggravate the patients’symptoms.The existence of occlusal interferences could be a threat to the health of stomatognathic system.