Suomela Elli, Alanko Outi, Tuomisto Martti T, Svedström Erkki, Peltomäki Timo, Suominen Auli, Soukka Tero, Svedström-Oristo Anna-Liisa
Pediatric Dentistry and Orthodontics, Institute of Dentistry, University of Turku, FI-20014,Turku, Finland.
Faculty of Social Sciences (Psychology), Tampere University, FI-33014,Tampere, Finland.
Eur J Orthod. 2025 Jun 12;47(4). doi: 10.1093/ejo/cjaf062.
To analyze changes in patients' temporomandibular dysfunction (TMD) symptoms during orthodontic-surgical treatment and to investigate associations between symptoms, findings in temporomandibular joints (TMJs), satisfaction with occlusal function, psychological distress, and orthognathic quality of life (OQoL).
Thirty-six consecutive female patients started orthodontic-surgical treatment, and 28 voluntary controls participated. Patients and controls filled in a semi-structured diary (regarding satisfaction and TMD symptoms) and the Orthognathic Quality of Life Questionnaire (OQLQ); patients also filled in the Symptom Checklist-90 (SCL-90). Patients' data were analyzed before treatment (T1), after preoperative orthodontics (T3), and one year after jaw surgery (T5). Controls' data were collected at respective time points (CT1, CT2, CT3). Magnetic Resonance Imaging (MRI) studies were performed on patients' and controls' TMJs at T1/CT1.
Before surgery, patients reported more TMD symptoms than controls. The most frequent symptoms were head/neck pain, stiffness/fatigue of the jaws, and pain in jaw joints. The most common finding in TMJ-MRI was anterior disc displacement with or without reduction. One year after surgery, improvement was seen in patients' satisfaction and OQLQ scores. Patients' number of symptoms correlated negatively with satisfaction and positively with OQLQ scores. No significant correlations were found between the severity of TMJ-MRI findings and satisfaction, number of symptoms, OQLQ function, or sum score.
Although TMJ-MRI findings are common among orthodontic-surgical patients, they are not always reflected in subjective symptoms, nor in self-perceived treatment outcome. Individual characteristics, not detectable using objective measures, constitute an important aspect and should therefore reserve more emphasis.
分析正畸-正颌联合治疗期间患者颞下颌关节紊乱病（TMD）症状的变化，并探讨症状、颞下颌关节（TMJ）检查结果、咬合功能满意度、心理困扰与正颌生活质量（OQoL）之间的关联。
36例连续接受正畸-正颌联合治疗的女性患者及28例自愿参与的对照者。患者和对照者填写一份半结构化日记（关于满意度和TMD症状）以及正颌生活质量问卷（OQLQ）；患者还填写症状自评量表90（SCL-90）。在治疗前（T1）、术前正畸治疗后（T3）以及颌骨手术一年后（T5）分析患者数据。对照者的数据在相应时间点（CT1、CT2、CT3）收集。在T1/CT1对患者和对照者的TMJ进行磁共振成像（MRI）检查。
手术前，患者报告的TMD症状比对照者更多。最常见的症状是头/颈部疼痛、颌部僵硬/疲劳以及颌关节疼痛。TMJ-MRI最常见的表现是伴或不伴复位的关节盘前移位。手术后一年，患者的满意度和OQLQ评分有所改善。患者的症状数量与满意度呈负相关，与OQLQ评分呈正相关。未发现TMJ-MRI检查结果的严重程度与满意度、症状数量、OQLQ功能或总分之间存在显著相关性。
尽管TMJ-MRI检查结果在正畸-正颌联合治疗患者中很常见，但它们并不总是反映在主观症状或自我感知治疗结果中。个体特征无法通过客观测量检测到，是一个重要方面，因此应给予更多重视。
