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颞下颌关节盘移位作为骨关节炎危险因素的评估。

Evaluation of temporomandibular joint disc displacement as a risk factor for osteoarthrosis.

作者信息

Dias I M, Cordeiro P C de F, Devito K L, Tavares M L F, Leite I C G, Tesch R de S

机构信息

Faculty of Medicine, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.

Faculty of Dentistry, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.

出版信息

Int J Oral Maxillofac Surg. 2016 Mar;45(3):313-7. doi: 10.1016/j.ijom.2015.09.016. Epub 2015 Oct 21.

Abstract

Temporomandibular joint (TMJ) disc displacement is a clinical sign often found in patients with temporomandibular disorders (TMDs) and associated with TMJ osteoarthrosis. Osteoarthrosis is a degenerative joint disease that may be associated with pain and functional disability. The aim of this study was to evaluate the odds ratio (OR) of joints with disc displacement presenting osteoarthrosis via magnetic resonance imaging (MRI) analysis. In total, 224 TMJ images from patients with signs and symptoms of a TMD were evaluated. The OR, a measure of association, was used to calculate the likelihood of TMJ disc displacement (with or without reduction) with osteoarthrosis. Joints with anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDwoR) were 2.73- and 8.25-times, respectively, more likely to have osteoarthrosis. A nine-times greater likelihood of osteophyte occurrence was observed in cases of ADDwoR, whereas a lower OR for their occurrence (OR 2.96) was observed in cases of ADDwR. The significant OR of joints with disc displacement presenting osteoarthrosis, particularly in cases of ADDwoR, emphasizes the importance of accurate assessment of changes in disc position, which may be associated with other painful and functional disorders of the TMJ.

摘要

颞下颌关节(TMJ)盘移位是颞下颌关节紊乱病(TMDs)患者中常见的临床体征,且与TMJ骨关节炎相关。骨关节炎是一种退行性关节疾病,可能伴有疼痛和功能障碍。本研究的目的是通过磁共振成像(MRI)分析评估存在盘移位的关节出现骨关节炎的比值比(OR)。总共评估了224例有TMD体征和症状患者的TMJ图像。OR是一种关联度量,用于计算TMJ盘移位(伴或不伴复位)合并骨关节炎的可能性。伴有可复性盘前移位(ADDwR)和不可复性盘前移位(ADDwoR)的关节发生骨关节炎的可能性分别是其他关节的2.73倍和8.25倍。在ADDwoR病例中观察到骨赘出现的可能性高出9倍,而在ADDwR病例中观察到其出现的OR较低(OR 2.96)。存在盘移位的关节出现骨关节炎的显著OR,特别是在ADDwoR病例中,强调了准确评估盘位置变化的重要性,这可能与TMJ的其他疼痛和功能障碍相关。

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