Witter D J, Kreulen C M, Mulder J, Creugers N H J
Department of Oral Function and Prosthetic Dentistry, College of Dental Science, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
J Dent. 2007 Jun;35(6):521-7. doi: 10.1016/j.jdent.2007.02.003. Epub 2007 Apr 2.
To assess prevalence of cardinal signs and symptoms related to temporomandibular disorders (TMD) in subjects with shortened dental arches and to clarify the individual course of these signs and symptoms.
In this 9-year follow-up study, subjects with shortened dental arches (n=74) were compared with subjects with complete dental arches (n=72). Of three reported symptoms (pain, noises/clicking and restricted mobility of the lower jaw), and of two clinical signs (palpated clicking of the temporomandibular joint and restricted maximal mouth opening) estimates of mean scores were calculated by a mixed model. Suggested determinants for TMD (gender, time, bruxism, chewing side preference) were investigated by covariate analyses. Subjects with complete 9-year follow-up (shortened dental arches: n=42; complete dental arches: n=41) were described more detailed by frequency distributions, Pearson correlations of signs and symptoms, and fluctuation of the symptoms.
Covariate analyses using the mixed model revealed no significant differences between the shortened and the complete dental arch groups (p>0.05) with respect to symptoms and signs. Most prevailing effect was gender: females reported more frequently pain (p=0.05) and noises/clicking (p=0.03). Restricted mobility was significantly related with chewing side preference and bruxism habits (both: p=0.01). In both groups, subjects with complete 9-year follow-up had low prevalence of serious symptoms and signs and symptoms fluctuated without demonstrable correlation.
In this 9-year follow-up, subjects with shortened dental arches had similar prevalence, severity, and fluctuation of signs and symptoms related to TMD compared to subjects with complete dental arches.
评估牙弓缩短患者中与颞下颌关节紊乱病(TMD)相关的主要体征和症状的患病率,并阐明这些体征和症状的个体发展过程。
在这项为期9年的随访研究中,将牙弓缩短的受试者(n = 74)与牙弓完整的受试者(n = 72)进行比较。对于报告的三种症状(疼痛、弹响/喀哒声和下颌活动受限)以及两种临床体征(颞下颌关节触诊弹响和最大开口受限),采用混合模型计算平均得分估计值。通过协变量分析研究TMD的潜在决定因素(性别、时间、磨牙症、咀嚼侧偏好)。对有完整9年随访的受试者(牙弓缩短组:n = 42;牙弓完整组:n = 41),通过频率分布、体征和症状的Pearson相关性以及症状波动情况进行更详细的描述。
使用混合模型进行的协变量分析显示,牙弓缩短组和牙弓完整组在症状和体征方面无显著差异(p>0.05)。最主要的影响因素是性别:女性更频繁地报告疼痛(p = 0.05)和弹响/喀哒声(p = 0.03)。活动受限与咀嚼侧偏好和磨牙症习惯均显著相关(均为p = 0.01)。在两组中,有完整9年随访的受试者严重症状和体征的患病率较低,症状波动且无明显相关性。
在这项为期9年的随访中,与牙弓完整的受试者相比,牙弓缩短的受试者中与TMD相关的体征和症状在患病率、严重程度和波动方面相似。