Pullinger A G, Seligman D A, Gornbein J A
Section of Orofacial Pain and Occlusion, UCLA, School of Dentistry 90024.
J Dent Res. 1993 Jun;72(6):968-79. doi: 10.1177/00220345930720061301.
A multiple logistic regression analysis was used to compute the odds ratios for 11 common occlusal features for asymptomatic controls (n = 147) vs. five temporomandibular disorder groups: Disc Displacement with Reduction (n = 81), Disc Displacement without Reduction (n = 48), Osteoarthrosis with Disc Displacement History (n = 75), Primary Osteoarthrosis (n = 85), and Myalgia Only (n = 124). Features that did not contribute included: retruded contact position (RCP) to intercuspal position (ICP) occlusal slides < or = 2 mm, slide asymmetry, unilateral RCP contacts, deep overbite, minimal overjet, dental midline discrepancies, < or = 4 missing teeth, and maxillo-mandibular first molar relationship or cross-arch asymmetry. Groupings of a minimum of two to at most five occlusal variables contributed to the TMD patient groups. Significant increases in risk occurred selectively with anterior open bite (p < 0.01), unilateral maxillary lingual crossbite (p < 0.05 to p < 0.01), overjets > 6-7 mm (p < 0.05 to p < 0.01), > or > 5-6 missing posterior teeth (p < 0.05 to p < 0.01), and RCP-ICP slides > 2 mm (p < 0.05 to p < 0.01). While the contribution of occlusion to the disease groups was not zero, most of the variation in each disease population was not explained by occlusal parameters. Thus, occlusion cannot be considered the unique or dominant factor in defining TMD populations. Certain features such as anterior open bite in osteoarthrosis patients were considered to be a consequence of rather than etiological factors for the disorder.
采用多元逻辑回归分析计算11种常见咬合特征在无症状对照组(n = 147)与五组颞下颌关节紊乱症患者中的比值比:可复性盘移位组(n = 81)、不可复性盘移位组(n = 48)、有盘移位病史的骨关节炎组(n = 75)、原发性骨关节炎组(n = 85)和仅肌痛组(n = 124)。无显著影响的特征包括:从后退接触位(RCP)到牙尖交错位(ICP)的咬合滑动≤2 mm、滑动不对称、单侧RCP接触、深覆合、最小覆盖、牙中线差异、缺失牙≤4颗以及上颌下颌第一磨牙关系或跨牙弓不对称。至少两个至最多五个咬合变量的分组对颞下颌关节紊乱症患者组有影响。风险显著增加的情况分别为前牙开颌(p < 0.01)、单侧上颌舌侧反合(p < 0.05至p < 0.01)、覆盖> 6 - 7 mm(p < 0.05至p < 0.01)、后牙缺失> 5 - 6颗(p < 0.05至p < 0.01)以及RCP - ICP滑动> 2 mm(p < 0.05至p < 0.01)。虽然咬合对疾病组的影响并非为零,但每个疾病群体中的大部分变异不能由咬合参数解释。因此,在定义颞下颌关节紊乱症群体时,不能将咬合视为唯一或主导因素。骨关节炎患者的某些特征如前牙开颌被认为是该病症的结果而非病因。