Ⅲ类错合的矫治及咬合状况与颞下颌关节紊乱病相关性评估

Study of relation between temporomandibular disorder and occlusion in treated angle class Ⅲ malocclusion patients

目的比较正畸治疗和正畸正颌联合治疗安氏Ⅲ类错合后颞下颌关节紊乱病(TMD)发病率的差异,并评估咬合因素对TMD的影响程度。方法60例分为两组(正畸治疗组和正畸正颌联合治疗组),通过询问既往史并结合临床检查(TMJ和肌肉的触诊,下颌的运动范围,关节弹响及咬合情况)对TMD的症状和体征进行评估。结果对既往史的调查表明51.7%的患者没有TMD,36.7%的患者有轻微的TMD,11.7%的患者有中度的TMD;TMD及其程度与对Ⅲ类错合矫治的方法无显著性相关(P>0.05);TMD的发生和非工作侧的咬合干扰相关(P<0.05)。结论对Ⅲ类错合不同治疗方法(正畸治疗组和正畸正颌联合治疗组)的TMD发病率没有明显差异;非工作侧的咬合干扰可能是TMD的危险诱因。

Objective To compare the prevalence of temporomandibular disorders （TMD） in patients who accepted either orthodontic or ortho-surgieal treatment for Angle Class Ⅲ malocclusion and to assess the effect of occlusion on TMD. Method The sixty patients were divided into two groups according to orthodontic or orthodontic with orthognathic surgery treatment. TMD was evaluated by an anamnestie questionnaire and clinical examination which included TMJ and muscle palpation, mandibular active motion range, joint noises and occlusion examination. Results The anamnestic questionnaire showed 51.7% had no TMD, 36.7% had mild TMD and 11.7% had moderate TMD. The presence and severity of TMD did not show any relationship with the type of treatment （P〉0.05）. The X^2-test showed a positive association（P〈0.05） between TMD and occlusal interferences on non-working side. Conclusion There is no difference in TMD prevalence between the orthodontic group and the orthodontic followed by orthognathic surgery group. The interferences on non-working side could be occlusal risk factors for TMD.