咬合抬高对颞颌关节结构及症状的影响

目的：探讨深覆胎或牙齿重度磨耗病人咬合抬高后对颞颌关节结构及症状的影响.方法：随机选取近两年在我院口腔修复科就诊的深覆胎或重度磨耗患者36例为受试对象,其中男性21例,女性15例,年龄36-53岁,治疗前后常规进行颞颌关节的临床检查,拍摄双侧颞颌关节开闭口位核磁共振并对关节情况进行分析.结果：36例患者的72个关节中,治疗前可复性盘前移21个关节,治疗后10个,差异有统计学意义（P＜0.05）.不可复性盘前移14例,治疗后13例,差异无统计学意义（P＞0.05）.治疗前关节弹响13例,治疗后9例,差异无统计学意义（P＞0.05）.治疗前关节区轻度疼痛12例,治疗后4例,差异有统计学意义（P＜0.05）.治疗前关节区中度疼痛8例,治疗后7例,差异无统计学意义（P＞0.05）.治疗前关节区重度疼痛2例,治疗后2例,差异无统计学意义（P＞0.05）.结论：咬合抬高对于颞颌关节可复性关节盘前移位和轻度关节区疼痛有一定治疗作用,对于不可复性盘前移,弹响及中,重度疼痛无缓解作用.

Effect of bite opening on TMJ structure and symptom

Objective： To investigate the influence of bite opening to the TMJ structure and symptom in patients with deep overbite or serious teeth wear. Method： 36 patients with deep overbite or serious teeth wear in our department were randomly selected as subjects in recent two years, including 21 male and 15 female, with ages from 36-53 years old. Clinical examinations and MR/on TMJ of both sides at bite and open position were used to analyze TMJ problems. Results： There were statistical differences of the number of TMJ disc reversible advancement between before （21 joints） and after treatment （10 joints）. （P〈O.05）; while, there was no significant difference of irreversible advancement between before （14 joints） and after treatment （13 joints）. （P〉0.05） Among 12 joints with mild pain before treatment, 8 were cured （P〈0.05）, with statistical differences. Among 8 joints with moderate pain before treatment, only one were cured （P〉0.05）, without statistical differ- ence. For 2 joints with severe pain before treatment, neither of them was improved. Conclusion： Bite opening was proved to have some treatment effect on TMJ disc reversible advancement and mild pain, but no effect on irreversible advancement, clicking, moderate and severe pain.