Hirsch Christian, John Mike T, Stang Andreas
Department of Pediatric Dentistry, School of Dentistry, University of Leipzig, Leipzig, Germany.
Eur J Oral Sci. 2008 Dec;116(6):525-30. doi: 10.1111/j.1600-0722.2008.00581.x.
The aim of this study was to analyze whether generalized joint hypermobility (GJH) is a risk factor for temporomandibular disorders (TMD). We examined 895 subjects (20-60 yr of age) in a population-based cross-sectional sample in Germany for GJH according to the Beighton classification and for TMD according to the Research Diagnostic Criteria for TMD (RDC/TMD). After controlling for the effects of age, gender, and general joint diseases using multiple logistic regression analyses, hypermobile subjects (with four or more hypermobile joints on the 0-9 scale) had a higher risk for reproducible reciprocal clicking as an indicator for disk displacement with reduction (Odds Ratio (OR) = 1.68) compared with those subjects without hypermobile joints. Concurrently, subjects with four or more hypermobile joints had a lower risk for limited mouth opening (< 35 mm; OR = 0.26). The associations between GJH and reproducible reciprocal clicking or limited mouth opening were statistically significant in a trend test. No association was observed between hypermobility and myalgia/arthralgia (RDC/TMD Group I/IIIa). In conclusion, GJH was found to be associated with non-painful subtypes of TMD.
本研究的目的是分析全身关节活动过度（GJH）是否为颞下颌关节紊乱病（TMD）的一个风险因素。我们在德国一个基于人群的横断面样本中，根据Beighton分类法检查了895名年龄在20至60岁之间的受试者是否存在GJH，并根据颞下颌关节紊乱病研究诊断标准（RDC/TMD）检查其是否患有TMD。在使用多元逻辑回归分析控制年龄、性别和一般关节疾病的影响后，与无关节活动过度的受试者相比，关节活动过度的受试者（在0至9分的量表上有四个或更多活动过度的关节）作为可复性盘移位伴复位的指标，出现可复性的相互弹响的风险更高（优势比（OR）=1.68）。同时，有四个或更多活动过度关节的受试者出现张口受限（<35毫米；OR=0.26）的风险较低。在趋势检验中，GJH与可复性的相互弹响或张口受限之间的关联具有统计学意义。未观察到关节活动过度与肌痛/关节痛（RDC/TMD I/IIIa组）之间存在关联。总之，发现GJH与TMD的非疼痛性亚型有关。
