Manfredini Daniele, Perinetti Giuseppe, Guarda-Nardini Luca
a Assistant Professor, Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Italy.
Angle Orthod. 2014 Mar;84(2):310-5. doi: 10.2319/041613-295.1. Epub 2013 Aug 19.
To assess the association of several dental malocclusion features with temporomandibular joint (TMJ) click sounds in a population of temporomandibular disorder (TMD) patients.
Four hundred forty-two TMD patients (72% female; 32.2 ± 5.7 years, range 25-44 years) were divided into a TMJ clicking and a no-TMJ clicking group, based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) assessment. Seven occlusal features were recorded for each patient: (1) posterior crossbite, (2) overbite, (3) open bite, (4) overjet, (5) mediotrusive and (6) laterotrusive interferences and (7) retruded contact position to maximum intercuspation (RCP-MI) slide length. A logistic regression model was created to estimate the association of occlusal features with TMJ clicking.
The difference between the groups as for the prevalence of the various occlusal features was generally not statistically significant, with minor exceptions. Mediotrusive interferences (P = .015) and RCP-MI slide ≥2 mm (P = .001) were the two occlusal features that were associated with the probability of having TMJ clicking, even if the adjusted odds ratios for TMJ clicking were low for both variables (1.63 and 1.89, respectively). Moreover, the amount of variance in the prevalence of TMJ clicking that was predicted by the final model was as low as 4.5% (R(2) = 0.045).
Findings from the present investigation suggested that in a population of TMD patients, the contribution of dental malocclusion features to predict TMJ click sounds is minimal with no clinical relevance.
评估颞下颌关节紊乱病(TMD)患者群体中几种牙颌面畸形特征与颞下颌关节(TMJ)弹响的相关性。
根据颞下颌关节紊乱病研究诊断标准(RDC/TMD)评估,将442例TMD患者(72%为女性;年龄32.2±5.7岁,范围25 - 44岁)分为TMJ弹响组和无TMJ弹响组。记录每位患者的7种咬合特征:(1)后牙反合,(2)覆合,(3)开合,(4)覆盖,(5)正中干扰和(6)侧方干扰,以及(7)从后退接触位到最大牙尖交错位(RCP - MI)的滑动长度。建立逻辑回归模型以评估咬合特征与TMJ弹响的相关性。
两组在各种咬合特征患病率方面的差异通常无统计学意义,仅有少数例外。正中干扰(P = 0.015)和RCP - MI滑动≥2 mm(P = 0.001)是与TMJ弹响概率相关的两种咬合特征,尽管这两个变量的TMJ弹响调整比值比均较低(分别为1.63和1.89)。此外,最终模型预测的TMJ弹响患病率的方差量低至4.5%(R² = 0.045)。
本研究结果表明,在TMD患者群体中,牙颌面畸形特征对预测TMJ弹响的贡献极小,无临床相关性。