Sahebi Safoora, Moazami Fariborz, Afsa Masoomeh, Nabavi Zade Mohammad Reza
Assistant Professor, Department of Endodontics, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
J Dent Res Dent Clin Dent Prospects. 2010 Summer;4(3):95-7. doi: 10.5681/joddd.2010.024. Epub 2010 Sep 16.
Trauma is one of the major factors associated with temporomandibular joint disorders (TMD). These disorders result from macro-trauma or micro-trauma. Macro-trauma might be iatrogenic; for example, from intuba-tion procedures, third molar extraction procedures, and lengthy dental appointments. The aim of this study was to evaluate the effect of lengthy root canal therapy (more than 2 hours) on TMJ and its supporting structures.
Eighty patients whose root canal therapy session lasted more than 2 hours were examined for the status of TMJ and masticatory muscles. After one week the second part of the examination was carried out for TMJ problems and pain and tenderness levels of masticatory muscles. Data was analyzed using Wilcoxon statistical test.
Women showed more pain compared to men. There was a significant increase in pain in the external acoustic meatus examination one week after root canal therapy. Patients who were treated for their posterior teeth suffered more pain than those who were treated for the anteriors and premolars. Other aspects of the examination were not affected significantly by lengthy root canal therapy.
Lengthy dental treatments can harm TMJ and masticatory muscles and wide opening of the mouth during such appointments can worsen the situation. Therefore, it is wise to break the appointment into shorter intervals and let the patients rest during treatment to close their mouth to prevent iatrogenic damage to TMJ.
创伤是与颞下颌关节紊乱病(TMD)相关的主要因素之一。这些紊乱病由宏观创伤或微观创伤引起。宏观创伤可能是医源性的,例如,来自插管操作、第三磨牙拔除操作以及长时间的牙科诊疗。本研究的目的是评估长时间根管治疗(超过2小时)对颞下颌关节及其支持结构的影响。
对80名根管治疗疗程持续超过2小时的患者的颞下颌关节和咀嚼肌状况进行检查。一周后,针对颞下颌关节问题以及咀嚼肌的疼痛和压痛程度进行第二次检查。使用威尔科克森统计检验对数据进行分析。
女性比男性表现出更多疼痛。根管治疗一周后,外耳道检查中的疼痛有显著增加。治疗后牙的患者比治疗前牙和前磨牙的患者遭受更多疼痛。长时间根管治疗对检查的其他方面没有显著影响。
长时间的牙科治疗会损害颞下颌关节和咀嚼肌,在此类诊疗过程中张大嘴巴会使情况恶化。因此,明智的做法是将诊疗分成较短的时间段,并让患者在治疗期间休息以闭口,防止对颞下颌关节造成医源性损伤。