Ciancaglini R, Gherlone E F, Redaelli S, Radaelli G
Department of Biomedical Sciences and Technologies, San Paolo Hospital, University of Milan, Milan, Italy.
J Oral Rehabil. 2002 Nov;29(11):1082-90. doi: 10.1046/j.1365-2842.2002.00941.x.
The aim of this study was to describe the distribution of occlusal contacts in subjects with signs or symptoms of temporomandibular disorder (TMD), and to assess whether any difference exists with healthy subjects. Twenty-five university dental students with complete natural dentition who exhibited TMD (13 females and 12 males, age from 19 to 30 years) and 25 age- and sex-matched controls entered the study. Occlusal contacts were evaluated in the intercuspal position and wax registrations were made in all subjects. Occlusal contacts were classified according to location and intensity. No differences were found between TMD and control groups for the overall number and distribution of contacts or for any side and intensity of contact. An intra-subject analysis showed that TMD subjects had significantly greater bilateral asymmetry in the number of contacts than controls. Median absolute difference of the number of contacts on right and left sides was 3 (95% CI, 2-4) in TMD subjects and 2 (95% CI, 1-2) in controls. In TMD subjects with mono-lateral TMD there was a significant concordance (88.9%) between the side of disorder and the side of higher number of contacts. These findings, while confirming that a significant relationship exists between distribution of occlusal contacts and TMD, further suggest that in young adults it may be primarily expressed by asymmetries in occlusal contact patterns. Existence and aetiology of any association of TMD with occlusal contacts should be further investigated.
本研究的目的是描述患有颞下颌关节紊乱病(TMD)体征或症状的受试者的咬合接触分布情况,并评估与健康受试者相比是否存在差异。25名具有完整天然牙列且表现出TMD的大学牙科学生(13名女性和12名男性,年龄在19至30岁之间)和25名年龄及性别匹配的对照者进入了研究。在正中颌位评估咬合接触情况,并对所有受试者进行蜡记录。根据位置和强度对咬合接触进行分类。在接触的总数、分布、任何一侧以及接触强度方面,TMD组和对照组之间均未发现差异。受试者内分析显示,TMD受试者在接触数量上的双侧不对称性显著大于对照组。TMD受试者左右两侧接触数量的中位数绝对差为3(95%可信区间,2 - 4),对照组为2(95%可信区间,1 - 2)。在患有单侧TMD的受试者中,病变侧与接触数量较多侧之间存在显著一致性(88.9%)。这些发现虽然证实了咬合接触分布与TMD之间存在显著关系,但进一步表明,在年轻人中,这种关系可能主要表现为咬合接触模式的不对称性。TMD与咬合接触之间任何关联的存在及病因应进一步研究。