保守正畸治疗颞下颌关节紊乱病的长期稳定性研究

Long term stability of conservative orthodontic treatment of temporomandibular disorders

目的探讨保守正畸治疗颞下颌关节紊乱病(TMD)的长期稳定性。方法选取2005年1月-2010年12月该院治疗的TMD患者80例。所有TMD患者采用正畸治疗,比较保守正畸治疗1~5年后的临床疗效,并观察1例保守正畸治疗5年后的治疗效果。结果 TMD以21~30岁年龄段患者居多。80例TMD患者开口受限Ⅰ度15例(18.75%),Ⅱ度10例(12.50%),Ⅲ度1例(1.25%);开口型偏斜60例(75.00%),关节弹响35例(43.75%),关节区压痛34例(42.50%),面部咀嚼肌压痛18例(22.50%),骨质改变15例(18.75%)。保守正畸治疗TMD患者12、24、36、48及60个月后临床疗效有效率比较,差异无统计学意义(P>0.05)。1例TMD患者经保守正畸治疗2年后已无TMD症状,可咬合;治疗5年后无TMD症状,期间可维持咬合,颞下颌关节功能恢复良好。结论保守正畸治疗TMD可保持患者颞下颌关节功能的长期稳定性。

Objective To investigate long-term stability of conservative treatment of temporomandibular disorders（TMD）. Methods Totally 80 patients with TMD in our hospital from January 2005 to December 2010 were selected as study subjects. All TMD patients were compared 1 to 5 years after conservative orthodontic treatment, and the therapeutic effect of 1 case of conservative orthodontic treatment for 5 years was observed. Results The majority of TMD patients were at the age of 21 to 30. For the 80 cases of TMD, there were 15 cases（18.75%） with limited opening degree I, 10（12.5%） with degree Ⅱ, 1（1.25%） with degree Ⅲ, 60（75%） with open mouth deflection, 35（43.75%） with clicking of joint, 34（42.5%） with joint tenderness, 18（22.5%） with facial masticatory muscle tenderness, 15（18.75%） with bone changes. Clinical efficacy of orthodontic treatment on TMD patients were not significant different 12, 24, 36, 48 and 60 months after treatment（P 〉 0.05）. A patient of TMD was without TMD symptoms 2 years after conservative treatment and had good occlusion. After treatment for 5 years he had no TMD symptoms and could be maintained during the occlusion, his temporomandibular joint functioned well. Concluson Conservative orthodontic treatment can maintain long-term stability of temporomandibular joint function in TMD patients.