Surendran Aathira, Daigavane Pallavi, Shrivastav Sunita, Kamble Ranjit, Sanchla Abhishek D, Bharti Lovely, Shinde Mrudula, Pareek Aditya V
Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College and Hospital, Wardha, IND.
Orthodontics and Dentofacial Orthopedics, Datta Meghe Institute of Higher Education & Research, Wardha, IND.
Cureus. 2024 Sep 4;16(9):e68648. doi: 10.7759/cureus.68648. eCollection 2024 Sep.
Introduction Temporomandibular disorder (TMD) involves discomfort and impaired function in the masticatory muscles and temporomandibular joint (TMJ), with a multifaceted etiology that includes biomechanical, neuromuscular, psychological, and biological factors. This research aims to assess and correlate the hyoid bone position, airway dimensions, and psychological status in class II Hz (horizontal) and Vt (vertical) malocclusion cases with TMD in contrast to non-TMD class I cases. Methodology This research was carried out at the Orthodontics Department, Sharad Pawar Dental College and Hospital, Sawangi, with consent obtained from the ethical committee. A total of 63 adult patients with class I, class II horizontal, and class II vertical malocclusions were selected. TMD was diagnosed using the Helkimo index, and patients were categorized accordingly. Psychological status was evaluated using the Warwick-Edinburgh scale, while the placement of hyoid bone and airway dimensions were assessed using lateral cephalograms. Statistical analysis involved descriptive and inferential statistics using SPSS version 27.0, with a significance level of p < 0.05. Results The research showed a noteworthy difference in the hyoid bone's location, airway dimensions, and psychological status among the three groups. Class II TMD patients (both vertical and horizontal) exhibited higher hyoid bone positions and larger Go-Hy-Me angles (angle formed by the gonion-hyoid line and the hyoid-menton line) compared to class I patients. In addition, class II vertical TMD patients showed the most reduced airway dimensions. Psychological assessments indicated higher stress, anxiety, and depression levels in class II TMD patients, particularly in the vertical group, compared to class I non-TMD patients. Conclusion This study highlights the intricate relationships between hyoid bone position, airway dimensions, and psychological status in TMD patients. TMD patients present with hyoid bones positioned closer to the cranium and mandible, larger Go-Hy-Me angles, and reduced airway dimensions. Psychological distress exacerbates TMD symptoms, negatively impacting overall well-being and quality of life. Orthodontists should consider these interrelated factors when devising treatment plans to improve patient outcomes. Future longitudinal studies with larger samples and advanced imaging techniques are recommended to further elucidate these interactions.
引言
颞下颌关节紊乱病(TMD)涉及咀嚼肌和颞下颌关节(TMJ)的不适及功能受损,其病因是多方面的,包括生物力学、神经肌肉、心理和生物学因素。本研究旨在评估并关联II类Hz(水平)和Vt(垂直)错牙合伴TMD病例与非TMD I类病例的舌骨位置、气道尺寸和心理状态。
方法
本研究在萨旺吉的沙拉德·帕瓦尔牙科学院和医院正畸科进行,并获得了伦理委员会的批准。共选取了63例I类、II类水平和II类垂直错牙合的成年患者。使用赫尔基莫指数诊断TMD,并据此对患者进行分类。使用沃里克-爱丁堡量表评估心理状态,同时使用头颅侧位片评估舌骨位置和气道尺寸。统计分析采用SPSS 27.0版进行描述性和推断性统计,显著性水平为p < 0.05。
结果
研究表明,三组患者在舌骨位置、气道尺寸和心理状态方面存在显著差异。与I类患者相比,II类TMD患者(垂直和水平)的舌骨位置更高,下颌角-舌骨线与舌骨-颏下点线形成的Go-Hy-Me角更大。此外,II类垂直TMD患者的气道尺寸减小最为明显。心理评估表明,与I类非TMD患者相比,II类TMD患者,尤其是垂直组患者的压力、焦虑和抑郁水平更高。
结论
本研究强调了TMD患者舌骨位置、气道尺寸和心理状态之间的复杂关系。TMD患者的舌骨位置更靠近颅骨和下颌骨,Go-Hy-Me角更大,气道尺寸减小。心理困扰会加重TMD症状,对整体健康和生活质量产生负面影响。正畸医生在制定治疗计划时应考虑这些相互关联的因素,以改善患者的治疗效果。建议未来进行更大样本量和采用先进成像技术的纵向研究,以进一步阐明这些相互作用。