临床因素能否预测正颌患者术后颞下颌关节紊乱？一项对219例患者的回顾性研究。
Can clinical factors predict postoperative temporomandibular disorders in orthognathic patients? A retrospective study of 219 patients.
作者信息
Scolozzi Paolo, Wandeler Pierre-Antoine, Courvoisier Delphine S
机构信息
Head, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland.
Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 May;119(5):531-8. doi: 10.1016/j.oooo.2015.01.006. Epub 2015 Feb 3.
OBJECTIVE
To determine the predictive value of preoperative clinical factors for postoperative temporomandibular disorders (TMDs) in patients receiving combined surgical-orthodontic treatment.
STUDY DESIGN
TMDs were classified according to Research Diagnostic Criteria for TMD in 219 patients. The severity of the TMD was scored according to the Helkimo anamnestic index (Ai) and clinical dysfunction index (Di).
RESULTS
Anamnestic TMJ clicking was the only significant predictor of TMD (odds ratio [OR] = 3.61, P = .006). The mean difference between clinical dysfunction index points was significant for pain on masticatory muscle palpation.
CONCLUSION
This study demonstrated that in orthognathic patients, the following factors had high predictive value: (1) anamnestic TMJ clicking for TMD, (2) TMJ clicking, TMJ pain on palpation and bimaxillary surgery for Ai worsening, (3) maxillary retrusion and mandibular excess for Ai improvement, and (4) pain on masticatory muscle palpation for Di worsening.
目的
确定接受外科正畸联合治疗的患者术前临床因素对术后颞下颌关节紊乱病（TMDs）的预测价值。
研究设计
根据颞下颌关节紊乱病研究诊断标准对219例患者的颞下颌关节紊乱病进行分类。根据赫尔基莫记忆指数（Ai）和临床功能障碍指数（Di）对颞下颌关节紊乱病的严重程度进行评分。
结果
记忆性颞下颌关节弹响是颞下颌关节紊乱病的唯一显著预测因素（优势比[OR]=3.61，P=0.006）。咀嚼肌触压痛的临床功能障碍指数评分之间的平均差异具有统计学意义。
结论
本研究表明，在正颌患者中，以下因素具有较高的预测价值：（1）记忆性颞下颌关节弹响对颞下颌关节紊乱病的预测，（2）颞下颌关节弹响、触诊时颞下颌关节疼痛和双颌手术对Ai恶化的预测，（3）上颌后缩和下颌前突对Ai改善的预测，（4）咀嚼肌触压痛对Di恶化的预测。
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