Sipilä Kirsi, Ensio Kaisa, Hanhela Heike, Zitting Paavo, Pirttiniemi Pertti, Raustia Aune
Dept. of Prosthetic Dentistry and Stomatognathic Physiology Institute of Dentistry, University of Oulu, P.O. Box 5281, FIN-90014 Oulu, Finland.
Cranio. 2006 Oct;24(4):245-51. doi: 10.1179/crn.2006.039.
Facial pain has been considered a common symptom of temporomandibular disorders (TMD) with a multifactorial etiology. There is controversy regarding the role of occlusion in the background of facial pain and TMD. The aim of the study was to compare the occlusal relationships with two definite measurements in subjects with and without facial pain, in a population-based sample of young adults. The study is part of the Northern Finland 1966 Birth Cohort Project. A subsample of the cohort was formed based on a questionnaire and consisted of 104 subjects, including 52 subjects with facial pain and 52 non-pain controls. Analyses of the dental occlusion of the subjects were performed in gypsum casts by following two methods: 1. the Peer assessment rating (PAR), according to Richmond, et al. (Method 1), and 2. the bilateral canine relationship and the dental midline measurement by the method presented by Pirttiniemi, et al. (Method 2). Method 2 showed higher sensitivity in detecting sagittal occlusal discrepancies than Method 1. Assessment of the intermaxillary relationships in terms of the canine relation showed the lower canine to be more mesially located in the facial pain group, compared to the controls, measured by Method 2. It can be concluded that differences in occlusal sagittal relationships, especially mesial canine relation, seem to correlate with facial pain symptoms at population level.
面部疼痛被认为是颞下颌关节紊乱病（TMD）的常见症状，其病因是多因素的。关于咬合在面部疼痛和TMD背景中的作用存在争议。本研究的目的是在一个基于人群的年轻成年人样本中，比较有面部疼痛和无面部疼痛的受试者的咬合关系，并进行两种明确的测量。该研究是芬兰北部1966年出生队列项目的一部分。根据一份问卷从该队列中选取了一个子样本，由104名受试者组成，其中包括52名有面部疼痛的受试者和52名无疼痛的对照者。通过以下两种方法对受试者的石膏模型进行牙合分析：1. 根据里士满等人的方法（方法1）进行同伴评估评分（PAR）；2. 根据皮尔蒂涅米等人提出的方法（方法2）测量双侧尖牙关系和牙中线。方法2在检测矢状向咬合差异方面比方法1具有更高的敏感性。用方法2测量发现，与对照组相比，面部疼痛组在尖牙关系方面的颌间关系评估显示下尖牙位置更偏向近中。可以得出结论，在人群水平上，咬合矢状关系的差异，尤其是近中尖牙关系，似乎与面部疼痛症状相关。
