General Universitary Hospital of Valencia, 46014 Valencia, Spain.
Med Oral Patol Oral Cir Bucal. 2009 Dec 1;14(12):e628-34. doi: 10.4317/medoral.14.e628.
To define the clinical and radiological characteristics of the four most common presentations of temporomandibular dysfunction-myofascial pain (MFP), disc displacement with reduction (DDWR), disc displacement without reduction (DDWoR), and osteoarthrosis (OR)-and to identify the differences among them.
The study comprised a series of 850 patients (121 males and 729 females) seen between May 2003 and December 2006 in Valencia University General Hospital (Valencia, Spain) for temporomandibular joint disease (TMJD). An analysis was made of the possible etiological factors (stress, traumatisms, sleep disturbances, parafunctional habits, reason for consultation), possible pain sensations in response to palpation of the masticatory muscles, joint sounds, etc. A panoramic X-ray study was made on a routine basis, and in some patients (n = 54) the study was completed with a magnetic resonance imaging scan of the temporomandibular joints and related tissues. The differences between qualitative variables were examined by means of the chi-square test with R x C contingency tables and the Z-test, while quantitative variables were contrasted by analysis of variance (ANOVA) and post hoc testing (Scheffe).
The variables showing statistically significant differences among the four diagnostic categories were: patient age, sleep disturbances, stress, parafunctional habits, nibbling on hard objects and "other parafunctions", reason for consultation, mandibular movements, "non-evaluable" molar and canine relationship, ligament hyperlaxity, and panoramic X-ray alterations.
定义颞下颌功能紊乱中最常见的四种表现形式(肌筋膜疼痛、可复性关节盘前移位、不可复性关节盘前移位和骨关节炎)的临床和影像学特征,并确定它们之间的差异。
本研究纳入了 2003 年 5 月至 2006 年 12 月在西班牙瓦伦西亚大学综合医院就诊的 850 例颞下颌关节疾病患者(121 名男性和 729 名女性)。分析了可能的病因因素(压力、创伤、睡眠障碍、偏侧咀嚼习惯、就诊原因)、咀嚼肌触诊时可能出现的疼痛感觉、关节弹响等。常规进行全景 X 线检查,部分患者(n=54)还进行了颞下颌关节及其相关组织的磁共振成像检查。通过卡方检验(R x C 列联表和 Z 检验)比较定性变量之间的差异,通过方差分析(ANOVA)和事后检验(Scheffe)比较定量变量之间的差异。
在这四种诊断类别中,有统计学差异的变量包括:患者年龄、睡眠障碍、压力、偏侧咀嚼习惯、咬硬物和“其他偏侧咀嚼习惯”、就诊原因、下颌运动、“不可评估”的磨牙和尖牙关系、韧带松弛以及全景 X 线改变。