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错牙合畸形与颞下颌关节紊乱病的相关性:一项横断面研究。

Association of Malocclusion with Temporomandibular Disorders: A Cross-Sectional Study.

作者信息

Ângelo David Faustino, Faria-Teixeira Maria Cristina, Maffia Francesco, Sanz David, Sarkis Marcella, Marques Rute, Mota Beatriz, João Ricardo São, Cardoso Henrique José

机构信息

Instituto Português da Face, 1500-493 Lisbon, Portugal.

Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, 2430-028 Marinha Grande, Portugal.

出版信息

J Clin Med. 2024 Aug 20;13(16):4909. doi: 10.3390/jcm13164909.

Abstract

: Temporomandibular disorders (TMD) encompass a range of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and associated structures. This cross-sectional study, conducted in a Portuguese TMD department, aimed to assess the relationship between malocclusion and TMD severity. : Data on demographic variables, TMD clinical symptoms, and malocclusion classes were collected using the EUROTMJ database. The Chi-square test (χ) identified associations, with their intensity measured by Cramér's V (φc). : The study included 1170 patients (932 females and 238 males), with a mean age of 41.73 ± 16.80 years. Most patients exhibited Angle Class I malocclusion (85.5%), followed by Angle Class II (13.5%) and Angle Class III (1.1%). Class II malocclusion was associated with increased TMD severity ( < 0.001), higher myalgia levels ( = 0.002), more frequent disc displacement without reduction ( = 0.002) and lower maximum mouth opening values (Class II: 38.13 ± 7.78 mm, Class I: 39.93 ± 8.67 mm). Significant associations were also found between malocclusion type and arthralgia ( = 0.021), mouth-opening limitation ( = 0.016), and TMJ crepitus ( = 0.017). In cases of malocclusion, the presence of oral signs of bruxism explained the degree of myalgia, disc displacement, and severity ( = 0.003; = 0.048; = 0.045). : This study highlights that (1) the most common type of dental malocclusion in TMD patients was Class I; (2) Class II malocclusion was associated with increased TMD severity and oral signs of bruxism; and (3) Class III was rarely observed in TMD consultation. The findings suggest that bruxism behavior in cases of malocclusion may be significant in TMD.

摘要

颞下颌关节紊乱病(TMD)包括一系列影响颞下颌关节(TMJ)及相关结构的肌肉骨骼和神经肌肉疾病。这项横断面研究在葡萄牙的一个颞下颌关节紊乱病科室开展,旨在评估错牙合与颞下颌关节紊乱病严重程度之间的关系。

使用EUROTMJ数据库收集了人口统计学变量、颞下颌关节紊乱病临床症状和错牙合分类的数据。采用卡方检验(χ)确定关联,并通过克莱默V系数(φc)测量其强度。

该研究纳入了1170名患者(932名女性和238名男性),平均年龄为41.73±16.80岁。大多数患者表现为安氏I类错牙合(85.5%),其次是安氏II类(13.5%)和安氏III类(1.1%)。II类错牙合与颞下颌关节紊乱病严重程度增加相关(<0.001)、肌痛水平较高(=0.002)、盘不可复移位更频繁(=0.002)以及最大开口度值较低(II类:38.13±7.78毫米,I类:39.93±8.67毫米)。在错牙合类型与关节痛(=0.021)、开口受限(=0.016)和颞下颌关节弹响(=0.017)之间也发现了显著关联。在错牙合病例中,磨牙症的口腔体征的存在解释了肌痛、盘移位和严重程度的程度(=0.003;=0.048;=0.045)。

这项研究强调

(1)颞下颌关节紊乱病患者中最常见的牙错牙合类型是I类;(2)II类错牙合与颞下颌关节紊乱病严重程度增加和磨牙症的口腔体征相关;(3)III类在颞下颌关节紊乱病会诊中很少观察到。研究结果表明,错牙合病例中的磨牙症行为在颞下颌关节紊乱病中可能具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57cd/11355311/5edd38d3976b/jcm-13-04909-g001.jpg

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