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正畸治疗与颞下颌关节紊乱病患者的颅颈姿势:一项观察性研究。

Orthodontic Treatment and Craniocervical Posture in Patients with Temporomandibular Disorders: An Observational Study.

机构信息

CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde, 4585-116 Gandra-Paredes, Portugal.

CIAFEL, Faculdade de Desporto da Universidade do Porto, 4200-450 Porto, Portugal.

出版信息

Int J Environ Res Public Health. 2021 Mar 23;18(6):3295. doi: 10.3390/ijerph18063295.

Abstract

Orthodontic treatment acts through the application of forces and/or by stimulating and redirecting the functional forces within the craniofacial complex. Considering the interrelationship between craniomandibular and craniocervical systems, this intervention may alter craniocervical posture. Thus, our aim is to (a) compare craniocervical posture, hyoid bone position, and craniofacial morphology before, after, and also in the contention phase at least one year after the orthodontic treatment, in patients with temporomandibular disorders and (b) to verify whether the presence of condylar displacement, the skeletal class, or the facial biotype interferes with the abovementioned outcomes. To do so an observational, analytical, longitudinal, and retrospective design study was carried out. A non-probabilistic convenience sampling method was applied. The sample consisted of clinical records of patients diagnosed with temporomandibular disorders in order to compare pre-orthodontic treatment with post-orthodontic treatment ( = 42) and contention phase data ( = 26). A cephalometric analysis of several variables was performed. The -value was set as 0.05. When the pre- and post-orthodontic treatment data were analyzed, there were statistically significant changes in variables concerning craniocervical posture (CV angle, C0-C1, and AA-PNS) and also concerning hyoid bone position (C3-Rgn). When pre- and post-orthodontic treatment and contention phase data were analyzed the variables concerning craniocervical posture (C0-C1, CVT/Ver, NSL/OPT, NSL/CVT, NSL/Ver; OPT/CVT, OPT/Ver) and facial biotype had statistically significant changes. This allowed us to conclude that in the sample studied, there were significant differences regarding hyoid bone position (pre- versus post-orthodontic treatment) and craniocervical posture (pre- versus post-orthodontic versus contention), with the craniocervical posture being prone to return to basal values. The presence of condylar displacement was found to significantly increase the H-H1 distance in the three moments of evaluation. Facial biotype was found to significantly increase the NSL/Ver angle on hypodivergent compared to hyperdivergent in the contention phase.

摘要

正畸治疗通过应用力和/或刺激和重新引导颅面复合体中的功能力来发挥作用。考虑到头颈系统与下颌骨系统之间的相互关系,这种干预可能会改变头颈姿势。因此,我们的目的是(a) 比较颞下颌关节紊乱患者在正畸治疗前后以及至少在正畸治疗后 1 年的对抗阶段的头颈部姿势、舌骨位置和颅面形态;(b) 验证髁突移位的存在、骨骼分类或面型是否会影响上述结果。为此,进行了一项观察性、分析性、纵向和回顾性设计研究。采用非概率便利抽样方法。该样本由诊断为颞下颌关节紊乱的患者的临床记录组成,以比较正畸治疗前与正畸治疗后(n=42)和对抗阶段数据(n=26)。对几个变量进行了头影测量分析。设值为 0.05。当分析正畸治疗前后的数据时,涉及头颈部姿势(CV 角、C0-C1 和 AA-PNS)和舌骨位置(C3-Rgn)的变量发生了统计学上的显著变化。当分析正畸治疗前后和对抗阶段的数据时,涉及头颈部姿势(C0-C1、CVT/Ver、NSL/OPT、NSL/CVT、NSL/Ver;OPT/CVT、OPT/Ver)和面型的变量发生了统计学上的显著变化。这使我们能够得出结论,在所研究的样本中,舌骨位置(正畸治疗前与治疗后)和头颈部姿势(正畸治疗前与治疗后与对抗)存在显著差异,头颈部姿势倾向于恢复到基础值。髁突移位的存在被发现显著增加了三个评估时刻的 H-H1 距离。面型被发现对头颈姿势呈低角的患者,在对抗阶段,NSL/Ver 角显著增加,而对头颈姿势呈高角的患者,该角度显著减小。

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