John Mike Torsten, Frank Henning, Lobbezoo Frank, Drangsholt Mark, Dette Karl-Ernst
Department of Prosthodontics, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.
J Prosthet Dent. 2002 Feb;87(2):197-203. doi: 10.1067/mpr.2002.121167.
Incisal tooth wear may be a sign of long-term bruxing behavior. Bruxism is purported to be a risk factor for temporomandibular disorders (TMD).
The purpose of this clinic-based case-control study was to investigate whether the wear of anterior teeth is associated with TMD.
Two hundred eight TMD patients and 172 control subjects were selected for participation. After exclusion of subjects with more than 1 missing premolar or molar zone in opposite arches, as well as subjects with missing or severely restored anterior teeth, 154 TMD patients and 120 control subjects were included in the study (age 31.2 +/- 13.4 years; range 13 to 76 years). Anterior tooth wear was assessed on casts with a 0 to 5 scale. A multiple logistic regression analysis, controlling for the effects of age and gender, was performed to investigate the relationship between tooth wear and TMD.
An odds ratio of 0.76 (95% confidence interval: 0.51 to 1.15) indicated that after adjusting for gender and age, the odds in favor of TMD decreased an estimated 24% for each additional unit of the mean tooth wear score. This result was not significant (P=.20).
Within the limitations of this study, incisal tooth wear (assessed on dental casts) was not significantly associated with TMD when the influence of age and gender was controlled. Based on these findings, a clinically relevant risk for TMD from incisal tooth wear can be excluded. Hence, the presented evidence does not support the idea that treatment of incisal tooth wear is indicated to prevent TMD.
切牙磨损可能是长期磨牙行为的一个迹象。磨牙症据称是颞下颌关节紊乱病（TMD）的一个风险因素。
本基于临床的病例对照研究的目的是调查前牙磨损是否与TMD相关。
选取208例TMD患者和172例对照受试者参与研究。排除对侧牙弓中缺失超过1颗前磨牙或磨牙区的受试者，以及缺失或严重修复过前牙的受试者后，154例TMD患者和120例对照受试者纳入研究（年龄31.2±13.4岁；范围13至76岁）。在模型上用0至5分的量表评估前牙磨损情况。进行多因素逻辑回归分析，控制年龄和性别的影响，以研究牙齿磨损与TMD之间的关系。
比值比为0.76（95%置信区间：0.51至1.15），表明在调整性别和年龄后，平均牙齿磨损评分每增加一个单位，患TMD的几率估计降低24%。该结果无统计学意义（P = 0.20）。
在本研究的局限性内，当控制年龄和性别的影响时，切牙磨损（在石膏模型上评估）与TMD无显著相关性。基于这些发现，可以排除切牙磨损导致TMD的临床相关风险。因此，现有证据不支持为预防TMD而治疗切牙磨损的观点。
