Huang D Z, Zhang Q, Zhai X T, Wang Y, Liu G, Hu M, Liu H C, Jiang H
Department of Prosthodontics, General Hospital of Chinese PLA, Beijing 100853, China.
Department of Radiology, General Hospital of Chinese PLA, Beijing 100853, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2021 Aug 9;56(8):753-758. doi: 10.3760/cma.j.cn112144-20210119-00029.
To analyze the clinical symptoms and types of disc displacement of patients with anterior disc displacement (ADD) of temporomandibular joint (TMJ) and to explore the correlation between chewing side preference (CSP) and the clinical symptoms and types of disc displacement of ADD patients. This was a cross-sectional study of the ADD patients diagnosed by clinical symptoms and MRI findings of TMJ in the Department of Stomatology, General Hospital of Chinese PLA from January 2018 to December 2019. A total of 111 ADD patients [33 males and 78 females, aged(31.0±10.9) years old] were included. The patients were divided into two groups according to whether they had CSP: non-CSP group (=40) and CSP group (=71). The clinical symptoms and types of ADD were observed and recorded. According to the specific side of CSP in the CSP group, the patients were further divided into the ipsilateral side and the contralateral side of CSP. The pain, TMJ sounds and the ADD types were also observed. square test was used to compare the pain, TMJ sounds, limited mouth opening and ADD types of the two groups. Binary Logistic regression model was used to analyze the correlation between CSP and clinical symptoms and ADD characteristics. The incidence of pain in the CSP group [89% (63/71)] was significantly higher than that in the non-CSP group [70% (28/40)] (<0.05). In CSP patients, the incidences of pain and joint sounds on the ipsilateral side of CSP were significantly higher than that on the contralateral side (<0.05). MRI showed that the incidence of bilateral ADD in the CSP group [58%(41/71)] was significantly higher than that in the non-CSP group [37%(15/40)] (<0.05).There were significant differences in the incidences of no disc displacement (DD), anterior disk displacement with reduction(ADDwR) and anterior disk displacement without reduction (ADDwoR) between ipsilateral and contralateral joints of the CSP patients (<0.05). There were no significant differences in the incidences of no DD, ADDwR and ADDwoR between left and right joints of the non-CSP patients (>0.05). The incidence of ADDwoR in ipsilateral side of the CSP patients was significantly higher than that in contralateral side (<0.05). Pain (=3.375) and the side of disc displacement (=2.278) in patients with ADD were positively correlated with CSP (<0.05). The clinical symptoms and types of disc displacement between patients with and without CSP were significantly different. The incidences of pain and bilateral disc displacement in the CSP group were significantly higher than those in the non-CSP group. In addition, the incidences of pain, TMJ sounds and anterior disk displacement without reduction on the ipsilateral side of patients with CSP were significantly higher than those on the contralateral side. The pain symptoms and side of disc displacement were positively related to CSP.
分析颞下颌关节（TMJ）盘前移位（ADD）患者的临床症状及盘移位类型，探讨咀嚼侧偏好（CSP）与ADD患者临床症状及盘移位类型之间的相关性。本研究为横断面研究，选取2018年1月至2019年12月在中国人民解放军总医院口腔科经TMJ临床症状及MRI检查确诊的ADD患者。共纳入111例ADD患者[男性33例，女性78例，年龄（31.0±10.9）岁]。根据是否有CSP将患者分为两组：非CSP组（=40）和CSP组（=71）。观察并记录ADD的临床症状及类型。根据CSP组中CSP的具体侧别，将患者进一步分为CSP同侧组和对侧组。同时观察疼痛、TMJ弹响及ADD类型。采用卡方检验比较两组的疼痛、TMJ弹响、张口受限及ADD类型。采用二元Logistic回归模型分析CSP与临床症状及ADD特征之间的相关性。CSP组疼痛发生率[89%（63/71）]显著高于非CSP组[70%（28/40）]（<0.05）。在有CSP的患者中，CSP同侧的疼痛及关节弹响发生率显著高于对侧（<0.05）。MRI显示，CSP组双侧ADD发生率[58%（41/71）]显著高于非CSP组[37%（15/40）]（<0.05）。CSP患者同侧和对侧关节的无盘移位（DD）、可复性盘前移位（ADDwR）和不可复性盘前移位（ADDwoR）发生率存在显著差异（<0.05）。非CSP患者左右关节的DD、ADDwR和ADDwoR发生率无显著差异（>0.05）。CSP患者同侧的ADDwoR发生率显著高于对侧（<0.05）。ADD患者的疼痛（=3.375）及盘移位侧别（=2.278）与CSP呈正相关（<0.05）。有CSP和无CSP患者的临床症状及盘移位类型存在显著差异。CSP组的疼痛及双侧盘移位发生率显著高于非CSP组。此外，CSP患者同侧的疼痛、TMJ弹响及不可复性盘前移位发生率显著高于对侧。疼痛症状及盘移位侧别与CSP呈正相关。
