Selaimen Caio M P, Jeronymo José C M, Brilhante Diego P, Lima Eduardo M, Grossi Patrícia K, Grossi Márcio L
Faculty of Dentistry, Pontifical Catholic University of Rio Grande do Sul--PUCRS, Brazil.
Angle Orthod. 2007 May;77(3):471-7. doi: 10.2319/0003-3219(2007)077[0471:ORFFTD]2.0.CO;2.
To determine the role of occlusal variables (overbite; overjet; number of anterior and posterior teeth; bilateral canine guidance on lateral and protrusive movements; anterior centric slide; Angle Classes I, II, and III malocclusion) as risk indicators for the development of temporomandibular disorders (TMDs).
Seventy-two TMD patients with myofascial pain, with or without limited opening and arthralgia, as well as 30 age- and gender-matched pain-free concurrent controls were included. The association (critical odds ratio [OR] = 2.0) between the significant occlusal variables and TMD was calculated. Confounders were controlled in the inclusion-exclusion criteria as well as in the analysis stage (unconditional logistic regression) by variation in the OR (15%).
Angle Class II malocclusion (crude OR = 8.0, confidence interval [CI] = 2.2 to 29.3) and the absence of bilateral canine guidance on lateral excursion (crude OR = 3.9, CI = 1.6 to 9.7) were statistically more common in patients than in controls. Spontaneous pain as well as pain on palpation (Class II or higher) were also statistically worse in TMD patients. Significant confounders (ie, employment, age, cigarette and alcohol consumption) acted as effect modifiers not changing the critical OR (adjusted OR Angle Class II and bilateral canine guidance = 8.3 to 12.4 and 2.2 to 4.1, respectively).
Absence of bilateral canine guidance on lateral excursion and particularly Angle Class II malocclusion were considered important risk indicators for the development of TMD in this investigation, even when some sociodemographic factors were considered as effect modifiers.
确定咬合变量（覆合；覆盖；前后牙数量；侧方和前伸运动时的双侧尖牙引导；前牙正中滑动；安氏Ⅰ、Ⅱ、Ⅲ类错牙合）作为颞下颌关节紊乱病（TMD）发病风险指标的作用。
纳入72例患有肌筋膜疼痛的TMD患者，伴有或不伴有开口受限和关节痛，以及30例年龄和性别匹配的无疼痛对照者。计算显著咬合变量与TMD之间的关联（临界比值比[OR]=2.0）。在纳入排除标准以及分析阶段（无条件逻辑回归）通过OR值变化15%来控制混杂因素。
安氏Ⅱ类错牙合（粗OR=8.0，置信区间[CI]=2.2至29.3）和侧方运动时缺乏双侧尖牙引导（粗OR=3.9，CI=1.6至9.7）在患者中比对照者在统计学上更常见。TMD患者的自发痛以及触诊痛（Ⅱ级或更高）在统计学上也更严重。显著的混杂因素（即就业、年龄、吸烟和饮酒）作为效应修饰因素，并未改变临界OR值（调整后的安氏Ⅱ类错牙合和双侧尖牙引导的OR分别为8.3至12.4和2.2至4.1）。
在本研究中，侧方运动时缺乏双侧尖牙引导，尤其是安氏Ⅱ类错牙合，被认为是TMD发病的重要风险指标，即使一些社会人口统计学因素被视为效应修饰因素。
