Keeling S D, McGorray S, Wheeler T T, King G J
Department of Orthodontics, College of Dentistry, University of Florida.
Am J Orthod Dentofacial Orthop. 1994 Mar;105(3):279-87. doi: 10.1016/S0889-5406(94)70122-9.
The relationship between temporomandibular joint (TMJ) sounds and a person's dental and skeletal characteristics is poorly understood. In this study, data were obtained from 3428 grade schoolchildren (mean age = 9.0 years, SD = 0.8, range 6 to 12 years), without a history of orthodontic treatment. Each child had been examined independently by one of six orthodontists to assess: TMJ sounds (none, click, crepitus), gender, age, race (white/black), skeletal relationships (convexity, maxillary, and mandibular positions), malocclusion (molar class, overjet, overbite, anterior crowding, posterior crossbite), maximum opening, chin trauma (none, cut, scar), and history of lower facial trauma. Temporomandibular joint sounds were present in 344 children (10.0% of the sample); 276 (8.1%) had an isolated unilateral sound, 254 (7.4%) had unilateral clicking, 50 (1.5%) had bilateral clicking, 22 (0.6%) had unilateral crepitus, and 11 (0.3%) had bilateral crepitus. Univariate analyses compared children with and without sounds for each variable; logistic regression analyses examined the relationship between groups of variables and TMJ sounds. The prevalence of TMJ sounds was associated with examiner (chi 2 = 23.4, df = 5, p < 0.001); increased prevalence of TMJ sounds occurred in children with maxillary anterior crowding (t = 2.8, p < 0.006), mandibular anterior crowding (t = 3.0, p < 0.002), and increased maximum opening (t = 4.7, p < 0.001). In contrast to other reports on children, the prevalence of joint sounds was not associated with age, race, gender, or molar class.(ABSTRACT TRUNCATED AT 250 WORDS)
颞下颌关节(TMJ)弹响与个体牙齿及骨骼特征之间的关系尚未得到充分了解。在本研究中,数据取自3428名小学生(平均年龄=9.0岁,标准差=0.8,年龄范围6至12岁),他们均无正畸治疗史。每名儿童均由六位正畸医生之一独立进行检查,以评估:TMJ弹响(无、弹响、摩擦音)、性别、年龄、种族(白人/黑人)、骨骼关系(凸度、上颌和下颌位置)、错牙合(磨牙分类、覆盖、覆牙合、前牙拥挤、后牙反牙合)、最大开口度、颏部外伤(无、切割伤、瘢痕)以及面下部外伤史。344名儿童(占样本的10.0%)存在颞下颌关节弹响;276名(8.1%)有孤立的单侧弹响,254名(7.4%)有单侧弹响,50名(1.5%)有双侧弹响,22名(0.6%)有单侧摩擦音,11名(0.3%)有双侧摩擦音。单因素分析比较了有和没有弹响的儿童在各变量上的差异;逻辑回归分析检验了变量组与TMJ弹响之间的关系。TMJ弹响的患病率与检查者有关(卡方=23.4,自由度=5,p<0.001);上颌前牙拥挤(t=2.8,p<0.006)、下颌前牙拥挤(t=3.0,p<0.002)以及最大开口度增加(t=4.7,p<0.001)的儿童中TMJ弹响的患病率增加。与其他关于儿童的报告不同,关节弹响的患病率与年龄、种族、性别或磨牙分类无关。(摘要截取自250字)