Kurita H, Uehara S, Zhao C, Zhiyong Z, Miyazawa H, Koike T, Kurashina K
Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan.
Dentomaxillofac Radiol. 2007 Mar;36(3):155-9. doi: 10.1259/dmfr/46387630.
The purpose of this study was to determine the extent to which baseline clinical and radiographic features were associated with long-term outcomes in patients with temporomandibular joint disorder (TMJD).
49 patients with unilateral radiographically proven TMJD were available in this study. Self-reported long-term (mean 96.2 months) outcomes (current joint pain, maximum mouth opening and joint noise) after TMJD treatments were assessed by questionnaire. The impact of multiple initial clinical/radiographic findings (gender, age at first visit, time interval between first visit and questionnaire survey, treatment method, disc displacement, disc morphology, disc mobility, condylar bony change and morphology of the articular eminence) on the long-term outcomes was assessed using stepwise multiple regression and logistic regression analysis.
Patient age at the first visit was significantly correlated with current joint pain. Disc mobility and morphology of the articular eminence were significantly correlated with current range of maximal mouth opening.
The results of this study suggest that patients who appeared symptomatic at a younger age or who initially had a fixed disc were the most likely to have recurrent or persisting clinical signs/symptoms of TMJD after 8 years.
本研究旨在确定颞下颌关节紊乱病(TMJD)患者的基线临床和影像学特征与长期预后的关联程度。
本研究纳入了49例经影像学证实为单侧TMJD的患者。通过问卷调查评估TMJD治疗后自我报告的长期(平均96.2个月)预后(当前关节疼痛、最大开口度和关节弹响)。使用逐步多元回归和逻辑回归分析评估多个初始临床/影像学发现(性别、初诊年龄、初诊与问卷调查之间的时间间隔、治疗方法、盘移位、盘形态、盘活动度、髁突骨质改变和关节结节形态)对长期预后的影响。
初诊时患者年龄与当前关节疼痛显著相关。盘活动度和关节结节形态与当前最大开口度显著相关。
本研究结果表明,年轻时出现症状或最初盘固定的患者在8年后最有可能出现TMJD复发或持续的临床体征/症状。