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与两种极端咬合特征相关的紧咬牙效应:颞下颌关节紊乱病患者群体的诊断模式

Jaw clenching effects in relation to two extreme occlusal features: patterns of diagnoses in a TMD patient population.

作者信息

Manfredini Daniele, Vano Michele, Peretta Redento, Guarda-Nardini Luca

出版信息

Cranio. 2014 Jan;32(1):45-50. doi: 10.1179/0886963413Z.0000000009.

Abstract

OBJECTIVE

The aim of this investigation was to compare the pattern of temporomandibular disorder (TMD) diagnoses in clenching patients with different occlusal features, the null hypothesis being that no between-group differences exist.

MATERIALS AND METHODS

Two groups of subjects receiving a jaw clenching diagnosis and having large overjet or anterior open bite (Group A; N=45, 75.5% females, mean age: 38.1 +/- 15.9 years) or normal occlusion (Group B; N=69, 71% females, mean age: 34.6 +/- 13.8 years) were recruited among a TMD patient population and were given Research Diagnostic Criteria for TMD (RDC/TMD) axis I diagnoses, namely, group I muscle disorders, group II disc displacements, and group III arthralgia/osteoarthritis/osteoarthrosis.

MAJOR FINDINGS

The distribution of RDC/TMD single and combined group diagnoses was significantly different between the two groups (P<0.05), with Group A subjects showing a higher prevalence of multiple diagnoses (60% versus 43.3%), as well as a higher prevalence of combined RDC/TMD axis I group II and III diagnoses (37.8% versus 20.2%). All TMD signs and symptoms were more frequent in the patients with large overjet or anterior open bite with respect to the patients with normal occlusion.

CONCLUSION

In a TMD patient population, jaw clenching may have different consequences in subjects with large overjet or anterior open bite with respect to subjects featuring normal occlusion.

摘要

目的

本研究旨在比较具有不同咬合特征的紧咬牙患者的颞下颌关节紊乱病(TMD)诊断模式,无效假设为两组之间不存在差异。

材料与方法

从TMD患者群体中招募两组受试者,一组为接受紧咬牙诊断且有较大覆盖或前牙开(A组;N = 45,女性占75.5%,平均年龄:38.1±15.9岁),另一组为咬合正常(B组;N = 69,女性占71%,平均年龄:34.6±13.8岁),并给予颞下颌关节紊乱病研究诊断标准(RDC/TMD)轴I诊断,即I组肌肉紊乱、II组盘移位和III组关节痛/骨关节炎/骨关节病。

主要发现

两组之间RDC/TMD单一和联合组诊断的分布有显著差异(P<0.05),A组受试者多重诊断的患病率更高(60%对43.3%),以及RDC/TMD轴I的II组和III组联合诊断的患病率更高(37.8%对20.2%)。与咬合正常的患者相比,所有TMD体征和症状在有较大覆盖或前牙开的患者中更常见。

结论

在TMD患者群体中,与咬合正常的受试者相比,紧咬牙在有较大覆盖或前牙开的受试者中可能产生不同的后果。

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