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一名患有下颌后缩和颞下颌关节紊乱的成年女性的正畸再治疗：病例报告

Orthodontic retreatment of an adult woman with mandibular backward positioning and temporomandibular joint disorder: A case report.

作者信息

Yu Li-Yuan, Xia Kai, Sun Wen-Tian, Huang Xin-Qi, Chi Jing-Yu, Wang Ling-Jie, Zhao Zhi-He, Liu Jun

机构信息

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China.

Department of Stomatology, Strategic Support Force Medical Center of PLA, Beijing 10010, China.

出版信息

World J Clin Cases. 2022 Jan 14;10(2):691-702. doi: 10.12998/wjcc.v10.i2.691.

DOI:10.12998/wjcc.v10.i2.691
PMID:35097096
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8771383/
Abstract

BACKGROUND

The role of occlusal factors on the occurrence of temporomandibular joint disorders (TMDs) is still unclear and it is tricky for orthodontists to treat malocclusions in patients with TMDs. We report the case of the second orthodontic treatment of an adult female with Class II division 2 malocclusion associated with TMD. With the removal of anterior occlusal interference, TMD symptoms were alleviated and cone beam computed tomography (CBCT) images showed the bilateral condyles shifted forward.

CASE SUMMARY

This case report presented an orthodontic retreatment of an adult female with TMD and mandibular backward positioning based on CBCT examination and Joint Space Index (JSI) analysis. The left and right JSI values of -38.5 and -52.6 indicated that the position of bilateral condyles had posterior displacement. Ten years prior to this evaluation, she underwent orthodontic treatment resulting in the extraction of two upper premolars and one lower central incisor. The joint symptoms, including pain and sounds, were alleviated along with verified mandibular forward repositioning by extraction of another lower central incisor.

CONCLUSION

Mandibular backward positioning could be associated with TMD. JSI analysis based on CBCT is a convenient way to examine condylar positions quantitatively.

摘要

背景

咬合因素在颞下颌关节紊乱病（TMD）发生中的作用仍不明确，正畸医生治疗患有TMD的错牙合患者颇具难度。我们报告了1例伴有TMD的安氏II类2分类错牙合成年女性的二次正畸治疗病例。随着前牙咬合干扰的消除，TMD症状得到缓解，锥形束计算机断层扫描（CBCT）图像显示双侧髁突向前移位。

病例摘要

本病例报告基于CBCT检查和关节间隙指数（JSI）分析，对1例患有TMD且下颌后缩的成年女性进行正畸再治疗。左右JSI值分别为-38.5和-52.6，表明双侧髁突位置有后移位。在此次评估前10年，她接受了正畸治疗，拔除了两颗上颌前磨牙和一颗下颌中切牙。通过拔除另一颗下颌中切牙，随着下颌向前重新定位得到证实，关节症状（包括疼痛和弹响）得以缓解。

结论

下颌后缩可能与TMD有关。基于CBCT的JSI分析是一种定量检查髁突位置的便捷方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/d8c09cd4f9ec/WJCC-10-691-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/2f07f973238d/WJCC-10-691-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/bc4af992906d/WJCC-10-691-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/2170dd5052bd/WJCC-10-691-g003.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/80e3f9d6d86c/WJCC-10-691-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/c5e23d2635c1/WJCC-10-691-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/8414abe931ef/WJCC-10-691-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/abcac073e95a/WJCC-10-691-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/d8c09cd4f9ec/WJCC-10-691-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/2f07f973238d/WJCC-10-691-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/bc4af992906d/WJCC-10-691-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/2170dd5052bd/WJCC-10-691-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/4a5905b02c47/WJCC-10-691-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/80e3f9d6d86c/WJCC-10-691-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/c5e23d2635c1/WJCC-10-691-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/8414abe931ef/WJCC-10-691-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/abcac073e95a/WJCC-10-691-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/facb/8771383/d8c09cd4f9ec/WJCC-10-691-g009.jpg

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