Kampe T
Swed Dent J Suppl. 1987;42:1-68.
In all, 125 individuals, 13-23 years old, with intact dentitions and 163 individuals, 13-20 years old, with dental fillings were included in a series of studies. The results of the studies suggest that subjects with intact dentitions have a lower prevalence and degree of signs and symptoms of mandibular dysfunction than subjects with restorations in the teeth. However, most signs and symptoms in both groups were mild and infrequent. The most common symptoms in both groups were TMJ-sounds, tiredness during chewing, and headache, and the most common clinical signs were TMJ-sounds and muscles tender to palpation. Fossa bottom facets were more common in restored dentitions and they often involved fillings. In restored dentitions, dentin facets were more common, the worn area was on average larger and the distal marginal crest of the second lower molars were more often worn indicating a difference in functional activity between the groups, with more parafunctional activity in restored dentitions. According to the Karolinska Scales of Personality (KSP), the subjects with restored dentitions had higher values on the "muscular tension" and "somatic anxiety" scales, i.e. dental restorations were more common in subjects with autonomic and motor disturbances related to anxiety-proneness. The subjects with restored dentitions had lower bite force values during "gentle biting" in the frontal region. The occlusal perception increased from the more posterior test position to the anterior one in both groups. The best tactile sensibility was found in the incisor region, where the subjects with restored dentitions tended to have better values. The higher prevalence and degree of clinically recorded dysfunction in subjects with restored dentitions was confirmed in the follow-up study. The findings of this investigation indicate a possible etiological significance of dental filling therapy in mandibular dysfunction. For the moment, however, we do not know if, how and to what extent occlusal factors, psychological differences between the subjects, or combinations of these or other factors are responsible for the development of signs and symptoms in the masticatory system. Nevertheless, the findings indicate that the factor "dental filling therapy" merits more consideration and more extensive research and should be included in epidemiological studies in the future. There is no indication in the results that toxic effects of the fillings could have influenced the results but further studies might be desirable, especially longitudinal comparisons between subjects with intact and restored dentitions.
共有125名年龄在13至23岁、牙列完整的个体以及163名年龄在13至20岁、有补牙的个体被纳入一系列研究。研究结果表明，牙列完整的受试者下颌功能障碍体征和症状的患病率及程度低于牙齿有修复体的受试者。然而，两组中的大多数体征和症状都很轻微且不常见。两组中最常见的症状是颞下颌关节弹响、咀嚼时疲劳和头痛，最常见的临床体征是颞下颌关节弹响和触诊时肌肉压痛。窝底小平面在有修复体的牙列中更常见，且常累及补牙。在有修复体的牙列中，牙本质小平面更常见，磨损区域平均更大，下颌第二磨牙的远中边缘嵴磨损更频繁，这表明两组之间功能活动存在差异，有修复体的牙列中存在更多的异常功能活动。根据卡罗林斯卡人格量表（KSP），有修复体的牙列的受试者在“肌肉紧张”和“躯体焦虑”量表上得分更高，即牙科修复体在与焦虑倾向相关的自主神经和运动障碍受试者中更常见。有修复体的牙列的受试者在额部区域“轻咬”时咬合力值较低。两组中，从测试位置越靠后到越靠前，咬合感知增强。在切牙区域发现最佳触觉敏感性，有修复体的牙列的受试者在该区域往往有更好的值。在随访研究中证实，有修复体的牙列的受试者临床记录的功能障碍患病率和程度更高。这项调查的结果表明牙科充填治疗在下颌功能障碍中可能具有病因学意义。然而，目前我们不知道咬合因素、受试者之间的心理差异，或者这些因素与其他因素的组合是否以及在多大程度上导致了咀嚼系统体征和症状的发生。尽管如此，研究结果表明“牙科充填治疗”这一因素值得更多关注和更广泛的研究，未来应纳入流行病学研究。结果中没有迹象表明补牙的毒性作用会影响结果，但可能需要进一步研究，尤其是对牙列完整和有修复体的受试者进行纵向比较。
