颞下颌关节紊乱病在不同年龄群体的调查研究

Clinical Research of Temporomandibular Disorders in the Elderly and College Students of Cantonese

目的：探讨不同年龄群体的颞下颌关节紊乱病（TMD）的患病情况,临床特点及其差异性。方法：采用随机整群抽样方法,抽取368名65-75岁广东籍老人和681名18-23岁广东籍大学生作为研究对象。应用非条件Logistic回归模型和χ^2检验对调查结果进行分析。结果：在老人组,TMD体征阳性者239名（239/368,64.9%）,表现为关节弹响和杂音46人次（46/368,12.5%）,下颌运动异常58人次（58/368,15.8%）,疼痛192人次（192/368,52.2%）,人均临床症状1.2（296/239）;在大学生组中,TMD体征阳性者286名（286/681,41.9%）,表现为关节弹响和杂音102名（102/681,15%）,下颌运动异常185名（185/681,27.2%）,疼痛127名（127/681,18.5%）,人均临床症状1.4（414/286）。老年人后牙缺失、偏侧咀嚼和牙合创伤是主要危险因素;而在大学生组,精神因素、错颌畸形/下颌第三磨牙阻生、偏侧咀嚼是这一年龄段人群TMD发生的主要危险因素。结论：广东籍老年人TMD的发病率高于大学生组,后牙缺失是老年人TMD发生的最主要致病因素;精神因素则是大学生群体TMD发病的首要致病因素。老年人首要临床症状是疼痛,而大学生则是弹响与杂音。

Objective：To compare the features of temporomandibular disorders（TMD）between the elderly and college students of Cantonese.Methods：A total of 368 elderlies and 681 college students were included in this study.Subjects with positive symptoms were chosen as experimental group,while the others without any symptoms as control group.The factors were analyzed by unconditional Logistic regression and Chi-square test.Results：In the elderly group,the incidence of TMD was 64.9%.Pain,mandibular movement impairment and joint noises in diminishing order were the three leading common symptoms.In the college group,42.0% of the students were found with positive symptoms.Joint noises,mandibular movement impairment,pain in diminishing order were the three leading common symptoms.Male and female showed significant differences.The unconditional Logistic regression showed that the loss of posterior teeth,unbalanced chewing and occlusal trauma were the major influencing factors in the elderly group.Meanwhile,the non-conditional Logistic regression showed that psychological factors,occlusal disorders/impaction of mandibular third molar,unbalanced chewing were the major influencing factors in the college student group.Conclusion：The incidence of TMD in the elderly was higher than that of college students in Guangdong.The leading etiological factor and the most common symptom of TMD for the elderly were different from those of college students.