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与颞下颌关节紊乱症的发生和持续相关的风险因素。

Risk factors associated with incidence and persistence of signs and symptoms of temporomandibular disorders.

机构信息

Department of Odontology, Umeå University, Sweden.

出版信息

Acta Odontol Scand. 2010 Sep;68(5):289-99. doi: 10.3109/00016357.2010.494621.

Abstract

OBJECTIVE

To analyze whether gender, self-reported bruxism, and variations in dental occlusion predicted incidence and persistence of temporomandibular disorder (TMD) during a 2-year period.

MATERIAL AND METHODS

The study population comprised 280 dental students at Umeå University in Sweden. The study design was that of a case-control study within a 2-year prospective cohort. The investigation comprised a questionnaire and a clinical examination at enrolment and at 12 and 24 months. Cases (incidence) and controls (no incidence) were identified among those without signs and symptoms of TMD at the start of the study. Cases with 2-year persistence of signs and symptoms of TMD were those with such signs and symptoms at all three examinations. Clinical registrations of baseline variables were used as independent variables. Odds ratio estimates and 95% confidence intervals of the relative risks of being a case or control in relation to baseline registrations were calculated using logistic regression analyses.

RESULTS

The analyses revealed that self-reported bruxism and crossbite, respectively increased the risk of the 2-year cumulative incidence and duration of temporomandibular joint (TMJ) signs or symptoms. Female gender was related to an increased risk of developing and maintaining myofascial pain. Signs of mandibular instability increased the risk of maintained TMD signs and symptoms during the observation period.

CONCLUSION

This 2-year prospective observational study indicated that self-reported bruxism and variations in dental occlusion were linked to the incidence and persistence of TMJ signs and symptoms to a higher extent than to myofascial pain.

摘要

目的

分析性别、自我报告的磨牙症以及牙齿咬合的变化是否会预测颞下颌关节紊乱(TMD)在 2 年内的发生和持续情况。

材料和方法

研究人群包括瑞典于默奥大学的 280 名牙科学生。研究设计为 2 年前瞻性队列的病例对照研究。该研究包括在入组时以及 12 个月和 24 个月时进行问卷调查和临床检查。在研究开始时没有 TMD 迹象和症状的参与者中确定病例(发生率)和对照组(无发生率)。在所有三次检查中均存在 TMD 迹象和症状的患者被确定为有 2 年持续性 TMD 迹象和症状的病例。使用基线变量的临床记录作为自变量。使用逻辑回归分析计算病例和对照组相对于基线登记的相对风险的优势比估计值和 95%置信区间。

结果

分析表明,自我报告的磨牙症和反颌分别增加了 2 年内累积发病率和颞下颌关节(TMJ)迹象或症状持续时间的风险。女性性别与发生和维持肌筋膜疼痛的风险增加有关。下颌不稳定的迹象增加了在观察期间维持 TMD 迹象和症状的风险。

结论

这项为期 2 年的前瞻性观察研究表明,自我报告的磨牙症和牙齿咬合的变化与 TMJ 迹象和症状的发生和持续时间的相关性比肌筋膜疼痛更高。

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