Broberg Karolina, Lindskog-Stokland Birgitta, Mejersjö Christina
Clinic of Orofacial Pain, University Clinics of Odontology, Public Dental Health, Region Västra Götaland, Gothenburg, Sweden.
Clinic of Orofacial Pain, Public Dental Health, Region Västra Götaland, Borås, Sweden.
Open Dent J. 2017 Dec 13;11:628-635. doi: 10.2174/1874210601711010628. eCollection 2017.
To study anterior bite opening of unknown cause presenting in adulthood regarding prevalence, symptoms of Temporomandibular Dysfunction (TMD) and possible causes of the bite opening.
Patients referred to two Orofacial Pain and TMD clinics with the complaint of recent anterior bite opening, presenting in adulthood and of unknown cause, were considered for the study. Patients with systemic rheumatic or neuromuscular diseases, degenerative joint disease, previous fractures of the jaws or orthodontic treatment, were excluded. The clinical examination was according to DC/TMD and extended for the occlusion. Reported symptoms, clinical signs, the occlusion and diagnoses found are presented. According to the information gained from the patient's history, previous occlusion and appearance, and present signs of parafunction, a possible association with the bite opening was suggested.
Anterior bite opening was found in 1.6% of the referred patients. Symptoms of tiredness and/or orofacial pain were reported by 62%, headache by 41%, TMJ clicking by 24% and sensitive/tender teeth by 41%. Parafunction or bruxism was reported by 2/3 of the patients. A previous period in life of TMD symptoms, before the bite opening, was reported by 66%. Myalgia and headache associated with TMD were frequently diagnosed. The use of a partial dental splint, tongue pressure and pregnancy were possible causes found for the bite opening.
Anterior bite opening can occur in adulthood without organic or systemic disease of the TMJ or masticatory muscles, and was frequently associated with muscle TMD symptoms.
研究成年期出现的不明原因前牙开合的患病率、颞下颌关节紊乱病（TMD）症状及可能的病因。
本研究纳入了因近期前牙开合前来两家口腔颌面疼痛与TMD诊所就诊、成年发病且病因不明的患者。排除患有全身性风湿或神经肌肉疾病、退行性关节病、既往颌骨骨折或接受过正畸治疗的患者。临床检查按照DC/TMD进行，并扩展至咬合情况。报告所发现的症状、临床体征、咬合情况及诊断结果。根据从患者病史、既往咬合情况和外貌以及目前的功能异常体征中获取的信息，提出与前牙开合可能的关联。
在转诊患者中，前牙开合的发生率为1.6%。62%的患者报告有疲劳和/或口腔颌面疼痛症状，41%有头痛，24%有颞下颌关节弹响，41%有牙齿敏感/压痛。2/3的患者报告有功能异常或磨牙症。66%的患者报告在出现前牙开合之前曾有过TMD症状期。经常诊断出与TMD相关的肌痛和头痛。发现使用局部牙垫、舌压力和怀孕可能是前牙开合的病因。
成年期可出现前牙开合，而无颞下颌关节或咀嚼肌的器质性或全身性疾病，且常与肌肉TMD症状相关。
