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先天性缺牙与城市体检人群成人颞下颌关节紊乱的相关性研究。

Association of congenitally missing teeth with adult temporomandibular disorders in the urban health checkup population.

机构信息

Health Management Center, Xiangya Hospital, Central South University, 87 Xiangya Road, 410008, Changsha, Hunan, P.R. China.

Changsha Health Vocational College, 410605, Changsha, Hunan, P.R. China.

出版信息

BMC Oral Health. 2023 Mar 30;23(1):188. doi: 10.1186/s12903-023-02855-w.

Abstract

BACKGROUND

Congenitally missing tooth is the most common dental abnormality which leaves spaces in the arch, leads to numerous forms of malocclusion due to the Bolton index discrepancy and is even associated with abnormal craniofacial morphology. Even though the roles of malocclusion and tooth loss in temporomandibular disorders (TMD) development remain controversial, basic researches have found some common molecules are involved in osteoarthritis and dental agenesis. However, the association of congenitally missing teeth with TMD is unknown. We hence investigated the association of congenitally missing teeth with TMD.

METHODS

A cross-sectional analysis of 586 control participants (male: 287, female: 299, 38.33 ± 11.65 years) and 583 participants with non-third molar congenitally missing teeth (male: 238, female: 345, 39.13 ± 11.67 years) who consecutively received routine dental and TMD checkup according to Diagnostic Criteria for Temporomandibular Disorders Axis I in Health Management Center, Xiangya Hospital was performed. Logistic regression analysis was used to study the association of congenitally missing teeth with TMD.

RESULTS

The congenitally missing teeth group included 581 hypodontia and 2 oligodontia participants. The congenitally missing anterior teeth participants, the congenitally missing posterior teeth participants and participants with both congenitally missing anterior and posterior teeth accounted for 88.34%, 8.40% and 3.26% of the congenitally missing teeth group respectively. Congenitally missing teeth group had greater ratios of females and orthodontic history. Participants with congenitally missing teeth had a significantly higher prevalence of overall TMD (67.24%) in comparison to control participants (45.90%). After adjusting age, gender, presence of congenitally missing teeth, number of congenitally missing teeth, number of non-congenitally missing teeth, number of dental quadrants with missing teeth, visible third molar and orthodontic history, the variables of age, gender, presence of congenitally missing teeth and number of dental quadrants with missing teeth were significant for overall TMD. Multivariable logistic regression analysis showed congenitally missing tooth was significantly related with overall TMD [odds ratio (OR):1.689(1.080-2.642), P = 0.022], intra-articular TMD [OR: 1.711(1.103-2.656), P = 0.017] and pain-related TMD [OR: 3.093(1.321-7.239), P = 0.009].

CONCLUSION

Congenitally missing tooth is a risk factor for TMD. When treating the congenitally missing teeth population, TMJ evaluation and multidisciplinary strategies are necessary.

摘要

背景

先天性缺牙是最常见的牙齿异常,它会在牙弓中留下空隙,导致由于 Bolton 指数差异而出现多种形式的咬合不正,甚至与颅面形态异常有关。尽管错牙合和牙齿缺失在颞下颌关节紊乱(TMD)发展中的作用仍存在争议,但基础研究发现一些共同的分子参与了骨关节炎和牙齿缺失。然而,先天性缺牙与 TMD 的关系尚不清楚。因此,我们研究了先天性缺牙与 TMD 的关系。

方法

对 586 名对照参与者(男性 287 名,女性 299 名,38.33±11.65 岁)和 583 名非第三磨牙先天性缺牙参与者(男性 238 名,女性 345 名,39.13±11.67 岁)进行了横断面分析,这些参与者连续在湘雅医院健康管理中心根据 TMD 轴 I 的诊断标准接受了常规牙科和 TMD 检查。使用逻辑回归分析研究先天性缺牙与 TMD 的关系。

结果

先天性缺牙组包括 581 例单纯性缺牙和 2 例少牙症患者。先天性缺前牙患者、先天性缺后牙患者和前牙和后牙均缺患者分别占先天性缺牙组的 88.34%、8.40%和 3.26%。先天性缺牙组中女性和正畸史的比例较高。与对照组(45.90%)相比,先天性缺牙组的总体 TMD(67.24%)患病率明显更高。在调整年龄、性别、先天性缺牙、先天性缺牙数量、非先天性缺牙数量、缺牙牙弓数量、可见第三磨牙和正畸史后,年龄、性别、先天性缺牙和缺牙牙弓数量等变量与总体 TMD 显著相关。多变量逻辑回归分析显示,先天性缺牙与总体 TMD 显著相关[比值比(OR):1.689(1.080-2.642),P=0.022]、关节内 TMD(OR:1.711(1.103-2.656),P=0.017)和疼痛相关 TMD(OR:3.093(1.321-7.239),P=0.009)。

结论

先天性缺牙是 TMD 的危险因素。在治疗先天性缺牙人群时,需要进行 TMJ 评估和多学科策略。

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