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年轻成人尸检中错牙合与颞下颌关节改变的相关性

Malocclusion associated with temporomandibular joint changes in young adults at autopsy.

作者信息

Solberg W K, Bibb C A, Nordström B B, Hansson T L

出版信息

Am J Orthod. 1986 Apr;89(4):326-30. doi: 10.1016/0002-9416(86)90055-2.

DOI:10.1016/0002-9416(86)90055-2
PMID:3457531
Abstract

The purpose of this study was to identify variables of malocclusion that might be associated with previously reported temporomandibular joint morphologic findings. Before removing the left TMJ from each of 96 cadavers (age means equals 26.4 +/- 6.8 years), an intraoral examination was performed. Angle classification, crossbite, overbite, and overjet were evaluated. These parameters were analyzed with respect to their association with the following TMJ features: overall shape of the condyle and temporal bone, gross and histologic evidence of remodeling, and position of the articular disk. When combined with age, Angle Class II and III dentitions were associated with temporal and condylar deviation in form (DIF) (P less than 0.05) and more Class II dentitions were accompanied by histologic evidence of remodeling changes in the TMJs. Crossbite was associated with increasing presence of DIF in all components (P less than 0.01). Anterior crossbite was associated with DIF on the articular eminence (P less than 0.01). Deep overbite was more common in persons with flat condyles, open mandibular fossae, and anterior extension of the temporal articular surfaces (P less than 0.05). Abnormal overjet was more evident in those with DIF in the disk (P less than 0.05); greater overjet was associated with disk displacement (P less than 0.05). Considered together, abnormal overbite and overjet were associated with more extensive DIF on the condyle (P less than 0.05). In conclusion, malocclusion was associated with morphologic changes in the TMJ, particularly when combined with age. This evidence supports the belief that longer exposure to malocclusion may be associated with more extensive TMJ changes.

摘要

本研究的目的是确定可能与先前报道的颞下颌关节形态学发现相关的错牙合变量。在从96具尸体(平均年龄为26.4±6.8岁)的每具尸体上取下左侧颞下颌关节之前,进行了口腔内检查。评估了安氏分类、反牙合、覆牙合和覆盖。分析了这些参数与以下颞下颌关节特征的相关性:髁突和颞骨的整体形状、重塑的大体和组织学证据以及关节盘的位置。当与年龄相结合时,安氏II类和III类牙列与颞骨和髁突形态偏差(DIF)相关(P<0.05),更多的II类牙列伴有颞下颌关节重塑变化的组织学证据。反牙合与所有组成部分中DIF的增加相关(P<0.01)。前牙反牙合与关节结节处的DIF相关(P<0.01)。深覆牙合在髁突扁平、下颌窝开放和颞关节面延伸的人群中更为常见(P<0.05)。异常覆盖在关节盘有DIF的人群中更为明显(P<0.05);更大的覆盖与关节盘移位相关(P<0.05)。综合考虑,异常覆牙合和覆盖与髁突上更广泛的DIF相关(P<0.05)。总之,错牙合与颞下颌关节的形态变化相关,尤其是与年龄相结合时。这一证据支持了这样一种观点,即长期暴露于错牙合可能与更广泛的颞下颌关节变化相关。

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