Yap Adrian Ujin, Lei Jie, Zhang Xiao-Han, Fu Kai-Yuan
Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, P.R. China.
Department of Dentistry, Ng Teng Fong General Hospital, and Faculty of Dentistry, National University Health System, Singapore.
Acta Odontol Scand. 2023 Oct;81(7):562-568. doi: 10.1080/00016357.2023.2215317. Epub 2023 May 21.
The relationships between cone-beam computed tomography (CBCT) findings, Temporomandibular disorder (TMD) symptoms, and signs were investigated in patients with TMJ degenerative joint disease (DJD).
Adult patients with Diagnostic Criteria for TMDs (DC/TMD)-defined intra-articular conditions were enrolled and subjected to CBCT assessment. The participants were organized into three groups, namely no (NT), early (ET), and late (LT) TMJ DJD based on radiographic findings. TMD symptoms/signs were appraised using the DC/TMD methodology. Statistical analyses were performed using Chi-square/non-parametric tests and Kappa statistics ( = 0.05).
The mean age of the participants ( = 877) was 30.60 ± 11.50 years (86.6% women). NT, ET, and LT were observed in 39.7%, 17.0%, and 43.3% of the study sample. Significant differences in the prevalence of TMD symptoms (TMD pain, TMJ sounds, opening, and closing difficulty) and signs (TMD/TMJ pain, TMJ clicking/crepitus, and opening limitation) were discerned among the three groups ( ≤ .001). TMD/TMJ pain and opening difficulty/limitation were more prevalent in early rather than late degenerative changes. While moderate agreements between symptoms and signs were observed for TMD pain/opening limitation, the concurrence for TMJ sounds was fair.
Young adults with TMJ sounds and pain should be examined with CBCT to establish the extent/progress of osseous changes.
研究颞下颌关节退行性关节病（DJD）患者锥束计算机断层扫描（CBCT）结果与颞下颌关节紊乱病（TMD）症状及体征之间的关系。
纳入符合颞下颌关节紊乱病诊断标准（DC/TMD）中关节内疾病定义的成年患者，并进行CBCT评估。根据影像学检查结果，将参与者分为三组，即无颞下颌关节DJD组（NT）、早期颞下颌关节DJD组（ET）和晚期颞下颌关节DJD组（LT）。采用DC/TMD方法评估TMD症状/体征。使用卡方检验/非参数检验和Kappa统计量进行统计分析（α = 0.05）。
参与者（n = 877）的平均年龄为30.60±11.50岁（女性占86.6%）。研究样本中NT、ET和LT分别占39.7%、17.0%和43.3%。三组之间在TMD症状（TMD疼痛、颞下颌关节弹响、开口和闭口困难）和体征（TMD/颞下颌关节疼痛、颞下颌关节弹响/摩擦音和开口受限）的患病率上存在显著差异（P≤0.001）。TMD/颞下颌关节疼痛和开口困难/受限在早期而非晚期退行性改变中更为普遍。虽然TMD疼痛/开口受限的症状和体征之间观察到中度一致性，但颞下颌关节弹响的一致性为中等。
有颞下颌关节弹响和疼痛的年轻成年人应进行CBCT检查，以确定骨质改变的程度/进展情况。
