Al-Jabrah Osama A, Al-Shumailan Yousef R
Department of Dentistry, King Hussein Medical Center, Royal Medical Services, Amman, Jordan.
Clin Oral Investig. 2006 Sep;10(3):167-73. doi: 10.1007/s00784-006-0046-3. Epub 2006 Apr 25.
To determine the prevalence of signs of a temporomandibular disorder (TMD) in completely edentulous patients wearing upper and lower complete dentures (CD) and to compare this to the prevalence of signs in partially edentulous patients wearing upper and lower clasp-retained acrylic removable partial dentures (RPD).
A questionnaire and a clinical examination were used to assess 200 patients. One hundred of these were complete denture wearers being treated for the provision of replacement CD. The other 100 patients were partially edentulous patients, who had RPD replacing upper and lower partially missing teeth and their supporting structures.
It was shown that there was a statistically significant difference between the two groups regarding the presence of temporomandibular signs. Partially edentulous patients wearing upper and lower RPD had a significantly higher prevalence of TMD signs than edentulous patients wearing CD (36% compared to 17%). They also exhibited significantly (P<0.04) more signs of joint tenderness (18%) on clinical examination compared to (5%) only in the CD-wearing patients. Tenderness upon palpation in the periauricular region was the most common site reported in both groups.
The partially edentulous patients (wearing RPD) exhibited more TMD signs when compared with the CD-wearing patients. Significantly, more partially edentulous patients had joint tenderness (P<0.04) than did CD-wearing patients. The masseter muscle most commonly demonstrated muscle tenderness.
确定佩戴上下全口义齿(CD)的无牙颌患者颞下颌关节紊乱病(TMD)体征的患病率,并与佩戴上下卡环固位丙烯酸可摘局部义齿(RPD)的部分牙列缺损患者的体征患病率进行比较。
采用问卷调查和临床检查对200例患者进行评估。其中100例为正在接受全口义齿修复治疗的全口义齿佩戴者。另外100例患者为部分牙列缺损患者,他们佩戴RPD修复上下部分缺失牙及其支持结构。
结果显示,两组在颞下颌关节体征方面存在统计学显著差异。佩戴上下RPD的部分牙列缺损患者的TMD体征患病率显著高于佩戴CD的无牙颌患者(分别为36%和17%)。与仅佩戴CD的患者(5%)相比,他们在临床检查中还表现出显著更多(P<0.04)的关节压痛体征(18%)。两组中最常见的压痛部位均为耳周区域触诊压痛。
与佩戴CD的患者相比,部分牙列缺损患者(佩戴RPD)表现出更多的TMD体征。值得注意的是,部分牙列缺损患者的关节压痛(P<0.04)明显多于佩戴CD的患者。咬肌最常表现出肌肉压痛。