435例正畸患者颞下颌关节紊乱病发病情况分析

Evaluation of temporomandibular joint disorders(TMD)in 435 patients receiving orthodontic treatment

目的 探讨正畸前后髁突骨质变化以及正畸治疗与颞下颌关节紊乱病 (temporomandibulardisorders,TMD)症状发生率的关系。方法 435例正畸患者拍摄正畸前后曲面体层片并记录正畸前后髁突骨质改变及其变化 ;正畸前进行TMD相关体征检查并记录正畸过程中因TMD症状就诊的病例。结果 正畸治疗前后髁突骨质异常改变的发生率分别为 3.7%和 6 .9% ,有显著性差异 (P <0 .0 5 )。 5 8例正畸前存在TMD体征 ,男性 19例 (14.1% ) ,女性 39例 (13.0 % ) ,发生率无性别差异 (P >0 .0 5 )。正畸过程中 8例因TMD相关症状就诊 ,其中 7例主诉为弹响伴疼痛。结论 正畸后髁突病变的发生率增加 ,不能完全用增龄性改变解释。正畸前存在关节弹响及髁突病变是正畸过程中出现疼痛。

Objective To determine the abnormal condyle radiographic findings before and after orthodontic treatment and the relationship between orthodontic treatment and the signs of TMD.Methods 435 orthodontic treated patients with age of 7 to 19 years,were included in the study.Panoramic radiographs were classified as 2 grade.Signs of TMD pre-treatment and the cases of seeking medical care in TMD clinic during orthodontic treatment were recorded.Results Radiographic findings were seen in 16 subjects( 3.7%) before treatment and in 30 subjects( 6.9%) after treatment(P< 0.05).The prevalence of TMD signs pre-treatment was 14.1% for male and 13% for female(P> 0.05).There were 7 cases with click and pain seeking care in TMD clinic during orthodontic treatment.Conclusion The occurrence of condyle osseous abonormalities was higher in the post-treatment group.It could not be attributed to increasing age.There was relationship between orthodontic treatment and TMD.Clicking and condylar osseous abnormalities before treatment may be the risk factors for pain and opening limitation during the treatment.