咬合紊乱导致的慢性应激对机体的影响

Effects of chronic stress caused by occlusal disorder on the body

咬合紊乱是上、下颌牙的静动态关系不协调的异常状态,临床中最常见的是因个别点的早接触而无法达到牙尖交错位或因咬合高点产生干扰的现象,可使牙周组织损伤、咀嚼功能下降、关节肌肉不适,甚至通过蓝斑-交感-肾上腺髓质系统和下丘脑-垂体-肾上腺轴的过度活化诱导血清皮质类固醇水平的升高导致机体慢性应激。本文就咬合紊乱导致的慢性应激对骨组织、口颌系统、情绪及认知功能影响的相关研究进行了综述。研究表明,咬合紊乱不仅导致口腔局部的骨丢失、全身骨量的减少,对口颌系统局部功能产生损害,在神经内分泌系统方面对机体的焦虑情绪、睡眠、认知功能及空间记忆能力亦有显著的负面作用。近年来对于咬合紊乱的关注呈上升趋势,早期发现并及时调整不协调的咬合关系已成为临床中不容忽视的问题。

Occlusal disorder is an abnormal condition in which the static and dynamic relations between the upper and lower teeth are not well aligned. The most common occlusal disorder in clinical practice is the inability to reach the intercuspal position due to early contact of individual points or occlusal interference due to occlusal high points,which can lead to periodontal tissue damage, decreased masticatory function, temporomandibular joint and muscle discomfort;these results can occur through the overactivation of the locus coeruleus-sympathetic-adrenal medullary system and hypothalamic-pituitary-adrenal axis induce elevated serum corticosteroid levels, which leads to chronic stress in the body. This article reviews the effects of chronic stress caused by occlusal disorder on bone tissue, stomatognathic system, emotional health and cognitive function. It has been found that occlusal disorders not only result in the loss of bone in the oral cavity, the reduction of bone mass in the whole body and damage to the local function of the stomatognathic system but also negatively affect the body’s anxiety, sleep, cognitive function and spatial memory ability as a result of the neuroendocrine changes. In recent years, concern about occlusal disorders has been on the rise. Early detection and timely adjustment of uncoordinated occlusion has become an issue that cannot be ignored in the clinic.