颞下颌关节病的颈部伴随症状及其治疗的临床研究

A primary study of neck symptoms with the temporomandibular joint disorder

目的 调查颞下颌关节病的颈背部伴随症状的临床发生情况及特征 ,探讨其治疗方法及疗效。方法 随机调查 10 0例患者中颈部伴随症状的发生情况 ,并和无关节病症状的对照组进行比较。对颞下颌关节病患者进行常规治疗 ,对有颈部症状的患者侧重进行修复、牙合垫和综合治疗并对治疗效果进行评价。结果 颞下颌关节病患者中伴随颈部症状的患者比例高于对照组。另外 ,前者的下颌偏斜比例及咬合异常比例均高于对照组。患者组中有明显咬合异常或下颌位不稳定的人 ,治疗开始一年后显效或有效率较高 ,而对有原发性颈椎病的人和可能伴有其它心理精神因素的人疗效较差。结论 颞下颌关节病和颈部症状有一定的关联。下颌位置改变有可能引起颈部关节及肌系统的改变 。

Objective To study the characteristics of concomitant neck symptoms of the temporomandibnlar joint disorder(TMD).Methods One hundred TMD patients were investigated to calculate the clinical incidence rate and characteristics of symptoms on neck region.One year after ordinary and prosthodontical treatment(for example,denture and splint),effectiveness was analyzed.One hundred adults without symptoms of TMD were also investigated as a control group.Results Twenty-two percent of the TMD patients had neck symptoms.The incidence rate and severity of the neck symptoms were worse than the control group.Among the patients with neck symptoms,deviation of mandibular midline occurred in a higher rate than the control group.Majority of the TMD patients with neck symptoms were effective to the treatments within the observation period except the patients with psychological problem and diagnosed cervical syndrome.Conclusion There is some connection between TWD and the neck symptoms.The position change of the mandible may influence the masticatory system and the neck function.