Department of Oral and Maxillofacial Surgery, Institution of Dental Medicine, Karolinska Institutet/Karolinska University Hospital, Huddinge, Sweden.
Int J Oral Maxillofac Surg. 2012 Sep;41(9):1046-50. doi: 10.1016/j.ijom.2012.02.024. Epub 2012 May 31.
The aim of the study was to investigate patients with temporomandibular joint (TMJ) disc derangement with its two clinical variants reciprocal clicking (RC) and chronic closed lock (CCL) with regard to the etiologic factors, previous jaw trauma and general (GJH) and local joint hypermobility (LJH). 42 patients (21 with RC and 21 with CCL) and 20 control individuals were studied. The patients and controls were asked whether they had sustained any jaw trauma in the past and were then examined for the presence of GJH and LJH, using defined criteria. Patient and control groups were compared. Statistical evaluation included χ(2) test and paired Student's t test. Odds ratio was calculated in order to assess the relative risk of developing RC and CCL when the etiological factor was present. The results showed a significant association between RC and GJH (OR=9.6, p=0.0010) as well as LJH (OR=38, p=0.0001). CCL was clearly associated with GJH (OR=7.5, p=0.0030) while its association with LJH was not significant (OR=9.5, p=0.0582). No significant association with previous trauma was found. The results indicate that GJH is an important etiologic factor for the development of RC and CCL of the TMJ.
本研究旨在探讨颞下颌关节（TMJ）盘移位患者的两种临床变异型——往复性弹响（RC）和慢性闭锁（CCL），分析其病因、既往颌创伤以及全身性（GJH）和局部关节过度活动（LJH）等因素。共纳入 42 名患者（RC 组 21 名，CCL 组 21 名）和 20 名对照组。询问患者和对照组既往是否有颌创伤，并使用特定标准检查 GJH 和 LJH 的存在情况。比较患者组和对照组。统计分析包括卡方检验和配对学生 t 检验。计算比值比（OR）以评估存在病因时发生 RC 和 CCL 的相对风险。结果显示，RC 与 GJH（OR=9.6，p=0.0010）和 LJH（OR=38，p=0.0001）明显相关。CCL 与 GJH 明显相关（OR=7.5，p=0.0030），而与 LJH 无显著相关性（OR=9.5，p=0.0582）。未发现与既往创伤有显著关联。研究结果表明，GJH 是 TMJ RC 和 CCL 发展的重要病因。
