Juhl G I, Jensen T S, Norholt S E, Svensson P
Department of Neurology and Danish Pain Research Centre, Aarhus University Hospital, Denmark.
J Oral Rehabil. 2009 Mar;36(3):199-209. doi: 10.1111/j.1365-2842.2008.01925.x.
The purpose of this prospective study was to investigate if third molar surgery is associated with the development of symptoms and signs of temporomandibular disorders (TMD) during a 6-month post-operative observation period using the Research Diagnostic Criteria for TMD (RDC/TMD) instrument. Seventy-two subjects eligible for third molar surgery under local anaesthesia (patients) were included. Patients were examined according to the RDC/TMD instrument at baseline, 1 week, 1 and 6 months after surgery. Twenty-five age- and sex-matched healthy non-operative control subjects (controls) were included and examined at baseline and at 6 months. In the patient group, we found: (i) reduced range of maximum jaw opening at one week after surgery (P < 0.001), (ii) increased characteristic pain intensity 1 week after surgery (P < 0.05), (iii) increased disability up to 1 month after surgery (P < 0.05), (iv) increased incidence of muscle pain on palpation up to 6 months after surgery (P < 0.05), (v) increased incidence of pain on palpation of the temporomandibular joint up to 6 months after surgery (P < 0.05) and (vi) increased incidence of painful TMD 6 months after surgery. But, when compared with untreated controls, subjects undergoing third molar surgery have a statistically insignificant increased incidence of TMD 6 months post-operatively.
这项前瞻性研究的目的是,使用颞下颌关节紊乱病研究诊断标准(RDC/TMD)工具,调查在术后6个月的观察期内,第三磨牙手术是否与颞下颌关节紊乱病(TMD)的症状和体征发展相关。纳入了72名符合局部麻醉下第三磨牙手术条件的受试者(患者)。在基线、术后1周、1个月和6个月时,根据RDC/TMD工具对患者进行检查。纳入了25名年龄和性别匹配的健康非手术对照受试者(对照组),并在基线和6个月时进行检查。在患者组中,我们发现:(i)术后1周最大张口度降低(P < 0.001),(ii)术后1周特征性疼痛强度增加(P < 0.05),(iii)术后1个月内功能障碍增加(P < 0.05),(iv)术后6个月内触诊时肌肉疼痛发生率增加(P < 0.05),(v)术后6个月内颞下颌关节触诊时疼痛发生率增加(P < 0.05),以及(vi)术后6个月疼痛性TMD发生率增加。但是,与未治疗的对照组相比,接受第三磨牙手术的受试者术后6个月TMD发生率虽有增加,但在统计学上无显著差异。