Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan.
J Oral Rehabil. 2020 Jan;47(1):36-41. doi: 10.1111/joor.12872. Epub 2019 Aug 28.
Phantom bite syndrome (PBS) is characterised by occlusal discomfort without corresponding dental abnormalities. Despite repeated, failed dental treatments, patients with PBS persist in seeking bite correction. PBS has been regarded as a mental disorder. However, we have reported that PBS patients with a dental trigger tend to have less psychiatric history than those without. Hence, the symptoms of PBS cannot be explained by a mental disorder alone, and it is unclear if mental disorders affect occlusal sensation.
To elucidate the pathophysiology of PBS, we analysed the dental history, PBS symptom laterality and psychiatric history of patients.
In this retrospective study, we reviewed outpatients with PBS who presented at our clinic between April 2012 and March 2017. Their medical records were reviewed for demographic data, medical history and laterality of occlusal discomfort.
Approximately half of the 199 enrolled patients had bilateral occlusal discomfort. In the others, the side with occlusal discomfort generally tended to be the one that had received dental treatment. There was no significant relationship between the side chiefly affected by occlusal discomfort and whether dental treatment had been received; however, the affected side differed depending on whether the patient had comorbid psychiatric disorders (P = .041).
The distributions of the side with symptoms of PBS were different between those with and without comorbid psychiatric disorders, suggesting that psychiatric disorders might affect occlusal sensation due to a subtle dysfunction in brain areas central to sensory integration. Central dysfunction might play an important role in PBS.
幻咬合综合征（PBS）的特征为咬合不适，但无相应的牙齿异常。尽管反复进行了失败的牙科治疗，PBS 患者仍坚持寻求咬合矫正。PBS 被认为是一种精神障碍。然而，我们曾报道过，有牙齿触发因素的 PBS 患者的精神病史往往少于没有牙齿触发因素的患者。因此，PBS 的症状不能仅用精神障碍来解释，也不清楚精神障碍是否会影响咬合感觉。
为了阐明 PBS 的病理生理学，我们分析了患者的牙科史、PBS 症状的偏侧性和精神病史。
在这项回顾性研究中，我们回顾了 2012 年 4 月至 2017 年 3 月期间在我们诊所就诊的 PBS 门诊患者。对他们的病历进行了回顾，以获取人口统计学数据、牙科史和咬合不适的偏侧性。
大约一半的 199 名入组患者存在双侧咬合不适。在其余患者中，咬合不适的主要侧通常倾向于曾接受过牙科治疗的一侧。咬合不适的主要侧与是否接受过牙科治疗之间无显著关系；然而，受影响的侧位因是否伴有共患精神障碍而不同（P=0.041）。
伴有和不伴有共患精神障碍的 PBS 患者的症状侧位分布不同，这表明精神障碍可能由于与感觉整合相关的大脑区域的微妙功能障碍而影响咬合感觉。中枢功能障碍可能在 PBS 中发挥重要作用。
