Lu Qian, Pang Shu-Ting, Zhou Jian-Ying, Lu Wen-Juan, Feng Yan-Fen, Zhang Qian, Wang Jing
Department of Oral medicine, Cangzhou People's Hospital. Cangzhou 061000, Hebei Province, China. E-mail:
Shanghai Kou Qiang Yi Xue. 2024 Oct;33(5):512-516.
To investigate the functional and structural characteristics of temporomandibular joint(TMJ) in introverted deep overbite patients with severe wear, to analyze the correlation between the vertical distance of the lower 1/3 of the face and TMJ space, and to compare the clinical efficacy of multidisciplinary treatment with orthodontics and prosthodontics on TMJ function.
Eighty patients with deep overbite and severe abrasion and forty subjects with normal occlusion admitted to our hospital from January 2019 to June 2023 were enrolled in this study. The clinical data were collected and the functional and structural characteristics of TMJ were collected. Eighty patients with deep overbite and severe abrasion were randomly divided into control group and experimental group, with 40 cases in each group. The control group was treated with restoration, and the experimental group was treated with orthodontic combined with restoration. The efficacy and CBCT imaging indexes were evaluated during the treatment. SPSS 26.0 software package was used for statistical analysis.
The mean Helkimo index of patients with deep overbite and severe abrasion was significantly higher than that of patients with normal occlusion(P＜0.05). CBCT scan showed that anterior space of TMJ in patients with deep overbite and severe abrasion significantly increased than those with normal occlusion(P＜0.05), while superior and posterior space were significantly decreased than those with normal occlusion(P＜0.05). Lateral cephalometric analysis showed that the vertical distance of submaxillofacial 1/3 in patients with deep overbite and severe abrasion significantly decreased than normal occlusion(P＜0.05). The Helkimo index of the two groups after treatment was significantly reduced (P＜0.05), and the Helkimo index of the experimental group was significantly lower than that of the control group (P＜0.05). The anterior TMJ spaces of the two groups significantly decreased after treatment, and the superior and posterior TMJ spaces were significantly increased(P＜0.05), but there was no significant difference in TMJ space between the experimental group and the control group(P＞0.05). The vertical distance of submaxillofacial 1/3 in patients in both groups significantly increased after treatment(P＜0.05). There were correlations between the vertical distance of lower one-third of face and the anterior, superior and posterior TMJ spaces(P＜0.05).
The clinical effect of dual disciplinary treatment of orthodontics and prosthodontics on TMJ function was significantly better than that of prosthodontics alone, and the effect on TMJ structure correction is similar to that of prosthodontics.
探讨内倾型深覆合重度磨耗患者颞下颌关节（TMJ）的功能及结构特点，分析面部下1/3垂直距离与TMJ间隙的相关性，并比较正畸与修复多学科联合治疗对TMJ功能的临床疗效。
选取2019年1月至2023年6月我院收治的80例深覆合重度磨耗患者和40例正常咬合受试者纳入本研究。收集临床资料并采集TMJ的功能及结构特点。80例深覆合重度磨耗患者随机分为对照组和试验组，每组40例。对照组采用修复治疗，试验组采用正畸联合修复治疗。治疗期间评估疗效及CBCT影像学指标。采用SPSS 26.0软件包进行统计分析。
深覆合重度磨耗患者的平均Helkimo指数显著高于正常咬合患者（P＜0.05）。CBCT扫描显示，深覆合重度磨耗患者TMJ的前间隙较正常咬合患者显著增大（P＜0.05），而上间隙和后间隙较正常咬合患者显著减小（P＜0.05）。头颅侧位片分析显示，深覆合重度磨耗患者颌面部1/3的垂直距离较正常咬合患者显著减小（P＜0.05）。两组治疗后的Helkimo指数均显著降低（P＜0.05），且试验组的Helkimo指数显著低于对照组（P＜0.05）。两组治疗后TMJ的前间隙均显著减小，上间隙和后间隙均显著增大（P＜0.05），但试验组与对照组的TMJ间隙差异无统计学意义（P＞0.05）。两组患者颌面部1/3垂直距离治疗后均显著增加（P＜0.05）。面部下1/3垂直距离与TMJ的前、上、后间隙均存在相关性（P＜0.05）。
正畸与修复多学科联合治疗对TMJ功能的临床疗效显著优于单纯修复治疗，对TMJ结构矫正的效果与修复治疗相似。
