正颌患者髁突形态变化与颞下颌关节紊乱病有关吗？
Are condylar morphologic changes associated with temporomandibular disorders in patients with orthognathia?
作者信息
Catherine Zulma, Courvoisier Delphine S, Scolozzi Paolo
机构信息
Chief Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland.
Biostatistician, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Aug;122(2):e44-50. doi: 10.1016/j.oooo.2016.03.006. Epub 2016 Mar 15.
OBJECTIVE
To determine the association between morphologic condylar changes and temporomandibular disorders (TMDs) in patients with orthognathia.
STUDY DESIGN
Data from 89 patients were analyzed. TMDs were classified according to the Research Diagnostic Criteria for TMDs. TMD severity was scored according to the Helkimo indices. Calculation of the condylar area, perimeter, and height was performed by using a specific computational method including panoramic radiography.
RESULTS
Sixty-five (73%) patients presented with morphologic condylar changes. Decreases in condylar perimeter and area were found to be predictors of postoperative TMDs (P = .009; odds ratio [OR] = 3.66) and disk displacement (P = .008; OR = 4.43), respectively. Condylar area and height decreases were associated with worsening of TMDs (P = .03 and 0.04).
CONCLUSIONS
This study demonstrated that in orthognathic patients, postoperative condylar changes are associated with postoperative TMDs as well as with the degree of TMD severity and that preoperative TMDs are associated with such condylar changes.
目的
确定正颌患者髁突形态变化与颞下颌关节紊乱病（TMD）之间的关联。
研究设计
分析了89例患者的数据。TMD根据TMD研究诊断标准进行分类。TMD严重程度根据赫尔基莫指数评分。使用包括全景X线摄影在内的特定计算方法计算髁突面积、周长和高度。
结果
65例（73%）患者出现髁突形态变化。髁突周长和面积减小分别被发现是术后TMD（P = 0.009；比值比[OR]=3.66）和盘移位（P = 0.008；OR = 4.43）的预测因素。髁突面积和高度减小与TMD加重相关（P = 0.03和0.04）。
结论
本研究表明，在正颌患者中，术后髁突变化与术后TMD以及TMD严重程度相关，且术前TMD与此类髁突变化相关。
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