Tosa H, Imai T, Watanabe F, Sumori M, Tsuchida T, Matsuno I, Nakamura S
Department of Orthodontics, Hokkaido University.
Nihon Kyosei Shika Gakkai Zasshi. 1990 Aug;49(4):341-51.
Occlusal disharmony is considered to be the most significant factor of temporomandibular joint (TMJ) dysfunction, but the relationship between malocclusion and TMJ dysfunction has been unknown yet. The purpose of present study was to investigate the relationship between TMJ dysfunction and occlusal disharmony (eccentric occlusal contacts and functional shift of the mandible) in orthodontic patients. The subjects were 533 orthodontic patients, 209 males and 324 females, who were received at the Department of Orthodontics, School of Dentistry, Hokkaido University from April 1985 to March 1988. Their ages ranged from 8 to 38 years old. All were prior to orthodontic treatment. The results were as follows 1. The prevalence of TMJ dysfunction was 27.6%, 24.9% in males and 29.3% in females. The difference was insignificant between males and females. 2. The patients with TMJ dysfunction increased after 13-15 years old, corresponding to dental age IV A (Hellman's classification). 3. In patients with TMJ dysfunction, the highest frequency of symptom of TMJ dysfunction was joint sounds (77.6%), the second was pain (22.4%), the third was disturbance of mandibular movement (4.8%). The complication of those symptoms were compounded in 26.3% of the total patients. 4. The prevalence of TMJ dysfunction had no relation to specific malocclusion and maxillofacial morphologic characteristic. 5. Most patients with TMJ dysfunction had occlusal disharmony (95.9%). 6. Eccentric occlusal contacts were found most frequently in patients with open bite and functional shift of the mandible was found most frequently in patients with deep bite. From these findings, the prevalence of TMJ dysfunction was frequent in orthodontic patients, however the symptoms were objective and the patients were not aware of TMJ dysfunction. TMJ dysfunction had no relation to specific malocclusion but some kinds of occlusal disharmony were easy to occur in specific malocclusion and TMJ dysfunction was induced by those etiological factors.
咬合不协调被认为是颞下颌关节（TMJ）功能障碍的最重要因素，但错牙合与TMJ功能障碍之间的关系尚不清楚。本研究的目的是调查正畸患者中TMJ功能障碍与咬合不协调（非正中咬合接触和下颌功能移位）之间的关系。研究对象为1985年4月至1988年3月在北海道大学牙科学院正畸科接受治疗的533例正畸患者，其中男性209例，女性324例。年龄在8至38岁之间。所有患者均在正畸治疗前。结果如下：1. TMJ功能障碍的患病率为27.6%，男性为24.9%，女性为29.3%。男女之间差异不显著。2. TMJ功能障碍患者在13 - 15岁后增加，对应于牙龄IV A期（赫尔曼分类）。3. 在TMJ功能障碍患者中，TMJ功能障碍症状出现频率最高的是关节弹响（77.6%），其次是疼痛（22.4%），第三是下颌运动障碍（4.8%）。这些症状的并发症在总患者中占26.3%。4. TMJ功能障碍的患病率与特定的错牙合和颌面形态特征无关。5. 大多数TMJ功能障碍患者存在咬合不协调（95.9%）。6. 非正中咬合接触在开牙合患者中最常见，下颌功能移位在深覆牙合患者中最常见。从这些发现来看，正畸患者中TMJ功能障碍的患病率较高，然而症状是客观存在的，患者并未意识到TMJ功能障碍。TMJ功能障碍与特定的错牙合无关，但某些类型 的咬合不协调在特定错牙合中容易出现，并且这些病因因素会诱发TMJ功能障碍。
