Dodić Slobodan, Sinobad Vladimir, Obradović-Djuricić Kosovka, Medić Vesna
Clinic for Prosthetic Dentistry, Faculty of Dentistry, University of Belgrade, Belgrade, Serbia.
Srp Arh Celok Lek. 2009 Nov-Dec;137(11-12):613-8. doi: 10.2298/sarh0912613d.
The influence of occlusal condition at the onset of temporomandibular disorders (TMD) has been strongly debated for many years and still is the source of controversy. Up to the eighties in the last century, the occlusal factors such as the presence of uncured malocclusions, discrepancies between intercuspal position and retruded contact position greater than two millimeters, retrusive and nonworking side interferences and loss of posterior teeth were considered to be the primary causes of TMD.
The aim of this study was to estimate the role of occlusal factor in the etiology of craniomandibular dysfunction and therapeutic effects of irreversible occlusal therapy (occlusal equilibration) in patients with TMD.
In the investigation we studied a group of 200 men and women. The average age of the selected patients was between 18 and 25 years. The purpose of TMD signs and symptoms was confirmed in every patient using a special functional analysis and evaluating the craniomandibular index (CMI) according to Fricton and Schiffman. The value of craniomandibular index was determined in the group of 15 patients with signs and symptoms of temporomandibular dysfunction. In the study groups occlusal equilibration (selective grinding) was performed according to Okeson using the central position of the mandible as the referent position in the occlusal therapy. The value of CMI was determined before and 30 days after occlusal equilibration.
The results of this study confirmed the significant reduction in the signs and symptoms of TMD after occlusal equilibration. The statistical elaboration of the differences between the values of CMI I (before treatment) and CMI II (30 days after treatment) revealed highly significant differences. The CMI I values in the group ranged between 0.076 and 0.346 with the mean value of 0.188 +/- 0.082.The values of CMI II ranged between 0.038 and 0.19 with the mean value of 0.038 +/- 0.053.
The study conformed the validity of irreversible occlusal therapy (selective grinding) in patients with TMD.
颞下颌关节紊乱病（TMD）发病时咬合状况的影响多年来一直备受争议，至今仍是争论的焦点。在上个世纪八十年代之前，诸如未矫治的错牙合畸形、牙尖交错位与后退接触位之间的差异大于两毫米、后退和非工作侧干扰以及后牙缺失等咬合因素被认为是TMD的主要病因。
本研究旨在评估咬合因素在颅下颌功能紊乱病因中的作用以及不可逆性咬合治疗（咬合调平）对TMD患者的治疗效果。
在这项调查中，我们研究了一组200名男性和女性。所选患者的平均年龄在18至25岁之间。通过特殊的功能分析并根据Fricton和Schiffman的方法评估颅下颌指数（CMI），确定每位患者的TMD体征和症状。在15名有颞下颌功能紊乱体征和症状的患者组中测定颅下颌指数的值。在研究组中，根据Okeson的方法进行咬合调平（选择性磨削），在咬合治疗中以下颌的中心位置作为参照位置。在咬合调平前和调平30天后测定CMI的值。
本研究结果证实咬合调平后TMD的体征和症状显著减轻。对CMI I（治疗前）和CMI II（治疗30天后）值之间的差异进行统计学分析显示出高度显著的差异。该组中CMI I值在0.076至0.346之间，平均值为0.188±0.082。CMI II值在0.038至0.19之间，平均值为0.038±0.053。
该研究证实了不可逆性咬合治疗（选择性磨削）对TMD患者的有效性。
