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前瞻性正畸患者的颞下颌关节紊乱。

Temporomandibular disorders in prospective orthodontic patients.

出版信息

Angle Orthod. 2021 May 1;91(3):377-383. doi: 10.2319/010720-863.1.

Abstract

OBJECTIVES

To determine the prevalence and severity of temporomandibular disorders (TMDs) in prospective orthodontic patients. The association between TMDs and malocclusion severity as well as the impact of TMDs on oral health-related quality of life (OHRQoL) were also examined.

MATERIALS AND METHODS

A total of 350 consecutive patients seeking orthodontic treatment were invited to participate in the study. The presence of TMDs was established with the Fonseca Anamnestic Index (FAI), while malocclusion severity and OHRQoL were evaluated using the Peer Assessment Rating (PAR) index and Oral Health Impact Profile-14 (OHIP-14), respectively. Data were analyzed using chi-square, Kruskal-Wallis, and Mann-Whitney U tests and Spearman's correlation (P < .05).

RESULTS

Of the 350 patients, 164 consented to participation. Data from 26 participants were excluded because of incomplete entries, and that from 138 subjects (mean age 21.02 ± 5.45 years) were examined. TMD-related symptoms were present in two-thirds of the subjects, with 20.3% experiencing moderate/severe TMDs. While no significant difference in PAR scores were observed between the group with no TMDs and those with TMDs, subjects with TMDs had significantly higher OHIP-14 summary/domain scores than those without TMDs. Although a moderately strong correlation was observed between the FAI and summary OHIP-14 scores (rs = 0.57), no association was observed between FAI and PAR index scores.

CONCLUSIONS

The prevalence of TMD-related symptoms in prospective orthodontic patients was high, emphasizing the importance of screening the masticatory system before initiating orthodontic therapy. Although the presence of TMDs was not associated with malocclusion severity, it had a significant negative impact on OHRQoL.

摘要

目的

确定前瞻性正畸患者颞下颌关节紊乱(TMD)的患病率和严重程度。还检查了 TMD 与错畸形严重程度的关系以及 TMD 对口腔健康相关生活质量(OHRQoL)的影响。

材料和方法

共邀请 350 名连续接受正畸治疗的患者参加研究。使用 Fonseca 病史指数(FAI)确定 TMD 的存在,同时使用同伴评估评分(PAR)指数和口腔健康影响量表-14(OHIP-14)评估错畸形严重程度和 OHRQoL。使用卡方检验、Kruskal-Wallis 检验和曼-惠特尼 U 检验以及斯皮尔曼相关分析(P<0.05)进行数据分析。

结果

在 350 名患者中,有 164 名同意参与。由于条目不完整,有 26 名参与者的数据被排除在外,对 138 名受试者(平均年龄 21.02±5.45 岁)的数据进行了检查。三分之二的受试者存在 TMD 相关症状,其中 20.3%的受试者患有中度/重度 TMD。虽然在无 TMD 组和有 TMD 组之间,PAR 评分没有显著差异,但有 TMD 的受试者的 OHIP-14 总分/领域评分明显高于无 TMD 的受试者。虽然 FAI 和 OHIP-14 总分之间存在中度强相关性(rs=0.57),但 FAI 与 PAR 指数评分之间没有关联。

结论

前瞻性正畸患者中 TMD 相关症状的患病率较高,这强调了在开始正畸治疗前对咀嚼系统进行筛查的重要性。虽然 TMD 的存在与错畸形严重程度无关,但它对 OHRQoL 有显著的负面影响。

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