Antonarakis Gregory S, Kalberer Nicole, Courvoisier Delphine S, Scolozzi Paolo
a Division of Orthodontics , University of Geneva , Geneva , Switzerland.
b Division of Fixed and Removable Prosthodontics , University of Geneva , Geneva , Switzerland.
Cranio. 2017 Nov;35(6):397-404. doi: 10.1080/08869634.2017.1283764. Epub 2017 Jan 27.
The aim of this study was to identify clinical factors predisposing to the development or worsening of temporomandibular disorders (TMDs) following orthodontic surgical treatment for Class III malocclusion.
A retrospective cohort study was performed on 88 patients with Class III malocclusion having undergone a combined orthodontic and orthognathic surgical treatment. Temporomandibular joint and masticatory muscle examinations were available prior to treatment and one year post-operatively. Multivariate logistic regression was used to predict the development of post-operative TMDs, and linear regression was used to predict the worsening of TMDs using Helkimo indices.
Patients with Class III malocclusion presenting with pre-treatment anamnestic TMJ clicking (OR = 5.8; p = 0.03) and undergoing bimaxillary osteotomy procedures (OR = 18.6; p = 0.04) were more at risk for the development of TMDs.
TMDs must be evaluated, monitored, and managed with caution in patients with Class III malocclusion presenting with pre-treatment joint clicking and who are planned for bimaxillary osteotomies.
本研究旨在确定在对Ⅲ类错牙合畸形进行正畸外科治疗后，易导致颞下颌关节紊乱病（TMDs）发生或加重的临床因素。
对88例接受正畸正颌联合手术治疗的Ⅲ类错牙合畸形患者进行了一项回顾性队列研究。在治疗前及术后一年进行了颞下颌关节和咀嚼肌检查。采用多因素逻辑回归预测术后TMDs的发生，并采用线性回归，利用赫尔基莫指数预测TMDs的加重情况。
治疗前有颞下颌关节弹响记忆的Ⅲ类错牙合畸形患者（OR = 5.8；p = 0.03）以及接受双颌截骨手术的患者（OR = 18.6；p = 0.04）发生TMDs的风险更高。
对于治疗前有关节弹响且计划进行双颌截骨手术的Ⅲ类错牙合畸形患者，必须谨慎评估、监测和处理TMDs。
