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使用正畸颌间弹力牵引的透明矫治器患者颞下颌关节紊乱病的患病率:采用颞下颌关节紊乱病诊断标准(DC/TMD)轴II评估的横断面研究。

Prevalence of temporomandibular disorders in clear aligner patients using orthodontic intermaxillary elastics assessed with diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: A cross-sectional study.

作者信息

Uzunçıbuk Hande, Marrapodi Maria Maddalena, Meto Aida, Ronsivalle Vincenzo, Cicciù Marco, Minervini Giuseppe

机构信息

Department of Orthodontics, Dentistry Faculty, Trakya University, Edirne, Turkey.

Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.

出版信息

J Oral Rehabil. 2024 Mar;51(3):500-509. doi: 10.1111/joor.13614. Epub 2023 Dec 2.

DOI:10.1111/joor.13614
PMID:38041596
Abstract

BACKGROUND

The objective of this investigation is to assess the relationship between the utilisation of orthodontic intermaxillary elastics and temporomandibular disorder (TMD) symptoms in clear aligner patients and to examine the correlation between the elastic usage time with the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)-Axis II Evaluation Forms.

METHODS

This study was carried out on a total of 40 clear aligner patients using intermaxillary elastics in the experimental group and 30 clear aligner patients who did not use any intermaxillary elastics in the control group. The data were evaluated using the Mann-Whitney U, chi-square, Fisher's exact chi-square, and Fisher Freeman Halton exact chi-square tests.

RESULTS

The characteristic pain intensity, mastication, mobility, communication, global and PHQ-9 scores of the experimental group were significantly higher than those of the control group (p < .05). The characteristic pain intensity score, interference score and chronic pain grade score of patients using Class III elastics were statistically significantly higher than those of patients using Class II elastics (p < .05). Patients who used elastics for less than 6 months had statistically significantly higher PHQ-9 scores than those who used elastics for more than 6 months (p < .05).

CONCLUSIONS

Orthodontic treatment may affect occlusion, bite force and jaw movement, which may cause or worsen TMD symptoms, and the DC/TMD questionnaires can determine if orthodontic patients acquire TMD by assessing their psychosocial state and pain-related problems.

摘要

背景

本研究的目的是评估使用正畸颌间弹力牵引装置与使用透明矫治器患者颞下颌关节紊乱病(TMD)症状之间的关系,并检验弹力牵引装置使用时间与颞下颌关节紊乱病诊断标准(DC/TMD)轴II评估表之间的相关性。

方法

本研究共纳入40例使用颌间弹力牵引装置的透明矫治器患者作为试验组,30例未使用任何颌间弹力牵引装置的透明矫治器患者作为对照组。采用Mann-Whitney U检验、卡方检验、Fisher精确卡方检验和Fisher Freeman Halton精确卡方检验对数据进行评估。

结果

试验组患者在特征性疼痛强度、咀嚼、活动、交流、整体及PHQ-9评分方面均显著高于对照组(p < 0.05)。使用III类弹力牵引装置患者的特征性疼痛强度评分、干扰评分和慢性疼痛分级评分在统计学上显著高于使用II类弹力牵引装置的患者(p < 0.05)。使用弹力牵引装置时间少于6个月的患者,其PHQ-9评分在统计学上显著高于使用弹力牵引装置时间超过6个月的患者(p < 0.05)。

结论

正畸治疗可能会影响咬合、咬合力和颌骨运动,进而可能导致或加重TMD症状,而DC/TMD问卷可以通过评估正畸患者的心理社会状态和疼痛相关问题来确定其是否患有TMD。

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