D'Ippolito Simona, Ursini Roberto, Giuliante Luca, Deli Roberto
Università Cattolica del Sacro Cuore, Istituto di Clinica Odontoiatrica, Largo F. Vito 1, 00168 Roma, Italy.
Via Michelini Tocci Franco 50, 00136 Roma (RM), Italy.
Int Orthod. 2014 Jun;12(2):222-38. doi: 10.1016/j.ortho.2014.03.013. Epub 2014 May 10.
Mandibular asymmetries are the fulcrum of many debates among modern orthodontists and maxillofacial surgeons. The interest is even greater when facial asymmetries are correlated to the development of TMJ symptoms and temporomandibular disorders (TMD).
The aim of this study is to investigate how mandibular asymmetries constitute etiological or predisposing factors for the development of temporomandibular disorders (TMD). We considered patients with mandibular asymmetries associated with TMD. Using orthodontic or surgical-orthodontic treatment, patients experienced correction of their TMJ symptoms. Thus, mandibular asymmetries represent a major risk factor for the development of TMD.
We studied a sample of 16 subjects aged between 14 and 36-years-old (11 females and 5 males) with mandibular asymmetries (81% structural asymmetry, 19% functional asymmetry). These subjects presented skeletal and dental malocclusions combined with several temporomandibular disorders, mostly due to muscle tension. In 100% of cases, patients received orthodontic treatment. We compared pre- and post-treatment postero-anterior (PA) cephalometric analyses in order to evaluate asymmetry resolution.
Comparison of measurements from pre- and post-therapy PA cephalograms showed resolution of mandibular asymmetries after treatment. The treatment resolved mandibular asymmetries and completely eliminated temporomandibular symptoms.
Orthodontic treatment of patients presenting mandibular asymmetry enables correction of all TMJ symptoms and TMD. Mandibular symmetries can therefore be considered to constitute etiological or predisposing factors for the development of TMD.
下颌不对称是现代正畸医生和颌面外科医生诸多争论的焦点。当面部不对称与颞下颌关节症状和颞下颌关节紊乱病（TMD）的发展相关时，人们的关注度更高。
本研究旨在探讨下颌不对称如何构成颞下颌关节紊乱病（TMD）发展的病因或诱发因素。我们研究了患有与TMD相关的下颌不对称的患者。通过正畸或外科正畸治疗，患者的颞下颌关节症状得到了改善。因此，下颌不对称是TMD发展的主要危险因素。
我们研究了16名年龄在14至36岁之间的受试者样本（11名女性和5名男性），他们存在下颌不对称（81%为结构不对称，19%为功能不对称）。这些受试者存在骨骼和牙齿错颌畸形，并伴有多种颞下颌关节紊乱病，主要是由于肌肉紧张所致。100%的患者接受了正畸治疗。我们比较了治疗前后的后前位（PA）头影测量分析，以评估不对称的改善情况。
治疗前后PA头影测量结果的比较显示，治疗后下颌不对称得到了改善。治疗解决了下颌不对称问题，并完全消除了颞下颌关节症状。
对下颌不对称患者进行正畸治疗能够纠正所有颞下颌关节症状和TMD。因此，下颌不对称可被视为TMD发展的病因或诱发因素。
