颞下颌关节紊乱、咬合力和颞下颌关节骨改变在高活动度埃勒斯-当洛斯综合征患者与健康对照组中的比较。
Temporomandibular disorders, bite force and osseous changes of the temporomandibular joints in patients with hypermobile Ehlers-Danlos syndrome compared to a healthy control group.
机构信息
Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Resource Center for Rare Oral Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
出版信息
J Oral Rehabil. 2022 Sep;49(9):872-883. doi: 10.1111/joor.13348. Epub 2022 Jun 30.
BACKGROUND
Ehlers-Danlos syndrome (EDS) is a hereditary disorder that affects the connective tissue and collagen structures in the body characterised by joint hypermobility, skin hyperextensibility and tissue fragility.
OBJECTIVE
The aim was to investigate temporomandibular disorders (TMD), bite force, teeth in occlusal contact and osseous changes of the temporomandibular joints (TMJs) in 26 patients with hypermobile EDS (hEDS), differentiated by a genetic test, compared to 39 healthy controls.
METHODS
Clinical examination according to Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), radiological examinations of the TMJs by cone-beam-computed tomographic (CBCT) scans, registration of bite force and teeth in occlusal contact was performed. Statistical analyses included Fisher's Exact Test, multiple logistic and linear regression models adjusted for age, gender and Body Mass Index (BMI).
RESULTS
Single symptoms and signs of TMD occurred significantly more often in hEDS (p = .002; p = .001; p = .003; p = <.0001; p = .012) and maximum mouth opening was significantly smaller in hEDS compared to controls (p = <.0001). The DC/TMD diagnosis myalgia, myofascial pain with referral, arthralgia, headache attributed to TMD, disc displacement disorders and degenerative joint disease occurred significantly more often in hEDS compared to controls (p = .000; p = .008; p = .003; p = .000; p = <.0001; p = .010, respectively). No significant differences were found in bite force and in teeth in occlusal contact between the groups (p > .05). On CBCT of the TMJs, subcortical sclerosis occurred significantly more often in hEDS compared to controls (p = .005).
CONCLUSION
Symptoms and signs of TMD and osseous changes of the TMJs occurred significantly more often in hEDS. Bite force and teeth in occlusal contact were comparable to controls.
背景
埃勒斯-当洛斯综合征（EDS）是一种遗传性疾病，影响身体的结缔组织和胶原结构，其特征是关节过度活动、皮肤过度伸展和组织脆弱。
目的
本研究旨在通过基因测试，对 26 例可活动 EDS（hEDS）患者和 39 名健康对照者的颞下颌关节（TMJ）进行 TMJ 紊乱、咬合力、咬合接触的牙齿和骨变化的研究。
方法
根据颞下颌关节紊乱（DC/TMD）的诊断标准进行临床检查，通过锥形束计算机断层扫描（CBCT）对 TMJ 进行影像学检查，记录咬合力和咬合接触的牙齿。统计分析包括 Fisher 精确检验、多元逻辑回归和线性回归模型，调整年龄、性别和体重指数（BMI）。
结果
hEDS 患者的 TMJ 单一症状和体征明显更为常见（p=0.002；p=0.001；p=0.003；p<0.0001；p=0.012），最大张口度明显小于对照组（p<0.0001）。与对照组相比，hEDS 患者的 DC/TMD 诊断肌痛、肌筋膜疼痛伴放射痛、关节炎、归因于 TMJ 的头痛、关节盘移位障碍和退行性关节病更为常见（p=0.000；p=0.008；p=0.003；p=0.000；p<0.0001；p=0.010）。两组之间的咬合力和咬合接触的牙齿无明显差异（p>0.05）。TMJ 的 CBCT 显示，hEDS 患者的皮质下硬化明显多于对照组（p=0.005）。
结论
hEDS 患者的 TMJ 紊乱和 TMJ 骨变化的症状和体征明显更为常见。与对照组相比，咬合力和咬合接触的牙齿无明显差异。
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