颞下颌关节紊乱病患者的三维咬合接触观察

Three dimensional analysis of the occlusion in patients with temporomandibular disorders

目的 :探讨颞下颌关节紊乱病 (TMD)患者的咬合异常特征。方法 :2 3名无症状全牙列大学生志愿者和 10 1名全牙列TMD患者 ,取研究模 ,从垂直向、颊舌向、近远中向三维方向观察、记录并以指数评价咬合特征 ;TMD患者摄许勒片及侧位体层片 ,弹响关节摄造影片 ,分析咬合指数与颞下颌关节 (TMJ)影像变化的关系。结果 :66.3 %的TMD患者有垂直向咬合异常 ,其垂直向咬合指数明显高于对照组 (P <0 .0 5 ) ;垂直向咬合异常与TMJ影像结果间未见明显相关性 (P >0 .0 5 )。结论 :垂直向咬合异常与TMD临床表现有密切关系。

Objectives: To investigate the occlusion features in thre e dimensions in patients with temporomandibular disorders(TMD). Methods: Occlusal casts were obtained from 23 asymptom volunteers and 101 TMD pati ents and were analyzed in three dimensions by scores vertically, mesio-distally and labial-or buccal-lingually. Bilateral TMJs of each TMD patient was examin ed with Schuller's radiograph and tomograph, the sounding TMJs were examined wit h arthrography. The relationship between occlusion scores and the changes shown in X-ray images were analyzed. Results: 66.3% TMD patients had abnormal occlusion in vertical direction.Abnormal occlusion in vertical directio n was correlated with TMD symptoms(P<0.05),but that was not related with X- ray imaging results(P> 0.05 ). Conclusion: Abnormal occlus ion in vertical direction is correlated with TMD symptoms.