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正畸治疗患者下颌髁突影像学表现的随访研究及其与颞下颌关节紊乱病的关联

A follow-up study of radiographic findings in the mandibular condyles of orthodontically treated patients and associations with TMD.

作者信息

Peltola J S, Könönen M, Nyström M

机构信息

Department of Dental Radiology, University of Helsinki, Finland.

出版信息

J Dent Res. 1995 Sep;74(9):1571-6. doi: 10.1177/00220345950740091101.

Abstract

Our earlier studies have shown that some radiographic structural findings in the mandibular condyles are more common in orthodontically treated populations than in normal populations. To test the hypothesis that these findings are stable, we studied condylar findings in panoramic radiographs longitudinally in 39 subjects and in 39 sex- and age-matched controls. The subjects had condylar findings at the end of orthodontic treatment at about 15 years of age; no such findings were seen in the controls. The subjects and controls were re-examined radiographically about 12 years after the posttreatment radiographic examination. We also tested the hypothesis that radiographic condylar findings are associated with temporomandibular disorders (TMD). No statistically significant differences were found between subjects and controls in terms of reported subjective TMD symptoms. Clinically, the subjects had temporomandibular joint (TMJ) crepitation significantly more frequently (27%) than controls (8%) (p < 0.05). Crepitation correlated with some reported symptoms and clinical signs, suggesting that osteoarthrosis might have been an important etiological factor for TMD in the present subjects. At the follow-up examination, radiographic condylar findings were seen in 25 subjects and in four controls (p < 0.001). The condylar findings varied greatly between the time of orthodontic treatment and follow-up in the subjects. The findings had become more severe in 49% of the subjects, more often in females than in males (p < 0.05), whereas in 28% of the subjects the condylar findings had disappeared. Although the radiographic findings after orthodontic treatment fluctuated with age, in most adolescents with changes in their condyles, these findings remained constant or became more severe.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们早期的研究表明,正畸治疗人群下颌髁突的一些影像学结构表现比正常人群更为常见。为了验证这些表现是稳定的这一假设,我们对39名受试者和39名年龄及性别匹配的对照者的全景X线片进行了髁突表现的纵向研究。这些受试者在约15岁正畸治疗结束时存在髁突表现;对照者未发现此类表现。在治疗后X线检查约12年后,对受试者和对照者进行了再次X线检查。我们还验证了影像学髁突表现与颞下颌关节紊乱病(TMD)相关的假设。在报告的主观TMD症状方面,受试者和对照者之间未发现统计学上的显著差异。临床上,受试者颞下颌关节(TMJ)弹响的发生率显著高于对照者(分别为27%和8%,p<0.05)。弹响与一些报告的症状和临床体征相关,提示骨关节炎可能是本研究中受试者TMD的一个重要病因。在随访检查中,25名受试者和4名对照者出现了影像学髁突表现(p<0.001)。受试者正畸治疗时与随访时的髁突表现差异很大。49%的受试者表现变得更严重,女性比男性更常见(p<0.05),而28%的受试者髁突表现消失。尽管正畸治疗后的影像学表现随年龄波动,但在大多数髁突有变化的青少年中,这些表现保持不变或变得更严重。(摘要截短至250字)

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