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被诊断为不可复性盘移位和骨关节炎的单侧颞下颌关节紊乱症在女性中表现出垂直颅面部不对称。

Unilateral temporomandibular joint disorders diagnosed as both disc displacement without reduction and osteoarthritis show vertical craniofacial asymmetry in women.

作者信息

Han Jung, Choi Sung-Hwa, Ahn Hyung Joon, Kwon Jeong-Seung, Park Younjung, Choi Yoon Jeong

机构信息

Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 03722 Seoul, Republic of Korea.

Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, 03722 Seoul, Republic of Korea.

出版信息

J Oral Facial Pain Headache. 2024 Sep;38(3):77-86. doi: 10.22514/jofph.2024.029. Epub 2024 Sep 12.

Abstract

This study investigated the effects of unilateral temporomandibular joint disorders (TMJDs), specifically disc displacement without reduction and osteoarthritis on one side of the temporomandibular joint (TMJ), on facial asymmetry in women, while the contralateral TMJ exhibits normal findings. Participants were retrospectively enrolled and divided into an affected group (n = 42 with unilateral TMJD) and a control group (n = 49 with bilateral healthy TMJs). The affected group was dagnosed with osteoarthritis on cone-bema computed tomograph and anterior disk displacement without reduction on magnetic resonance imaging. The control group showed normal findings bilaterally on both tests. Facial asymmetry was quantified using an asymmetry index derived from posteroanterior cephalograms, comparing both groups. The relationship between TMJD sub-findings and facial asymmetry was also investigated. Significant increases in the asymmetry indexes of the vertical distances from the antegonial notch and gonion to a horizontal reference plane were observed in the affected group ( < 0.05). Additionally, there was a noticeable upward canting of the maxillary, occlusal, and mandibular planes towards the affected side ( < 0.05). Horizontal asymmetry did not differ significantly between groups ( > 0.05). Parafunctional habits in the affected group were correlated with higher asymmetry indexes of the antegonial notch distance ( < 0.05). Women with unilateral TMJD exhibit significantly greater vertical facial asymmetry compared to those without TMJD. These findings may assist clinicians in diagnosing vertical asymmetry in patients with unilateral TMJD using cephalograms and in predicting facial asymmetry progression.

摘要

本研究调查了单侧颞下颌关节紊乱病(TMJDs),特别是颞下颌关节(TMJ)一侧的不可复性盘移位和骨关节炎,在对侧TMJ表现正常的情况下,对女性面部不对称的影响。研究采用回顾性招募的方式,将参与者分为患侧组(n = 42,单侧TMJD)和对照组(n = 49,双侧TMJ健康)。患侧组经锥形束计算机断层扫描诊断为骨关节炎,磁共振成像显示为不可复性前盘移位。对照组在两项检查中双侧均表现正常。使用从正位头影测量片得出的不对称指数对两组面部不对称情况进行量化比较。同时还研究了TMJD亚表现与面部不对称之间的关系。患侧组从角前切迹和下颌角到水平参考平面的垂直距离不对称指数显著增加(<0.05)。此外,上颌平面、咬合平面和下颌平面明显向患侧向上倾斜(<0.05)。两组之间的水平不对称无显著差异(>0.05)。患侧组的副功能习惯与角前切迹距离较高的不对称指数相关(<0.05)。与无TMJD的女性相比,单侧TMJD的女性面部垂直不对称明显更严重。这些发现可能有助于临床医生使用头影测量片诊断单侧TMJD患者的垂直不对称,并预测面部不对称的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f5f/11810645/26df1bcb49a6/fig1.jpg

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