阻塞性睡眠呼吸暂停低通气综合征患者使用口腔矫治器对颞下颌关节功能的影响

Effect of oral orthopaedic devices on temporomandibular joint function in patients with obstructive sleep apnea hypopnea syndrome

目的研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者使用口腔矫治器治疗对颞下颌关节功能的影响。方法选择2013年5月-2017年12月,在本院呼吸睡眠中心就诊并具有完整临床资料的OSAHS患者。随机分为口腔矫治器组和CPAP治疗组。比较两组治疗后的临床疗效及TMD发病率、慢性疼痛严重程度和颞下颌关节的功能损伤情况。结果治疗前后比较,两组患者PSG、ESS监测相关指标均明显改善。6个月时CPAP组各指标改善优于口腔矫治器组。口腔矫治器组疼痛疾病为主型TMD的发病率高于CPAP组,差异有统计学意义(P <0. 05)。两组下颌关节功能损伤程度无明显差异(P> 0. 05)。结论 OSAHS患者使用口腔矫治器治疗疼痛疾病为主型TMD的发病率明显增加,对下颌功能的影响与CPAP治疗比较无明显差异。

Objective To study the effect of oral orthopaedic therapy on temporomandibular joint function in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Patients with OSAHS were selected from the respiratory sleep center and randomly divided into the oral appliance group and the CPAP treatment group from May 2013 to December 2017.The clinical efficacy,incidence of TMD,severity of chronic pain and functional damage of temporomandibular joint were compared between the two groups.Results The indexes of PSG and ESS in both groups were improved significantly before and after treatment.At the 6th month,the indexes in the CPAP group were better than those in the oral group.The incidence of pain-related TMD in the oral group was higher than that in the CPAP group,and the difference was statistically significant(P<0.05).There was no significant difference in the degree of mandibular function injury between the two groups(P>0.05).Conclusion The incidence of pain-related TMD is significantly increased in patients with OSAHS treated with oral orthopaedic devices,but there is no significant difference in the effect on mandibular function,while compared with CPAP treatment.