De Boever A L, Keeling S D, Hilsenbeck S, Van Sickels J E, Bays R A, Rugh J D
Department of Orthodontics, University of Texas Health Science Center, San Antonio, USA.
J Orofac Pain. 1996 Winter;10(1):21-7.
This study assessed the relationship between temporomandibular disorders (TMD) and malocclusion in a group of 102 patients with horizontal mandibular deficiency who had elected mandibular advancement surgery. The prevalence of TMD as reflected by the overall Craniomandibular Index, Dysfunction index, and Muscle index scores was within the range of non TMD populations (mean Craniomandibular Index = 0.14; mean Dysfunction index = 0.12; mean Muscle index = 0.15). Forty-two percent of the patients exhibited essentially no signs of TMD, 7.8% had primarily muscle tenderness to palpation, 36.3% had joint sounds with or without temporomandibular joint tenderness, and 13.7% had combined muscle-joint signs. There were no convincing correlations among any of the cephalometric variables and Craniomandibular Index, Dysfunction index, and Muscle index scores. A subgroup of 30 of this patient population was evaluated both before and during orthodontic treatment just prior to surgery. No statistically significant changes were found in Craniomandibular Index, Dysfunction index, or Muscle index scores. Thus, a period of orthodontic treatment in these patients does not appear to increase the probability of TMD.
本研究评估了102例选择下颌前徙手术的下颌水平发育不足患者中颞下颌关节紊乱病(TMD)与错牙合畸形之间的关系。由整体颅下颌指数、功能障碍指数和肌肉指数评分所反映的TMD患病率处于非TMD人群范围内(平均颅下颌指数=0.14;平均功能障碍指数=0.12;平均肌肉指数=0.15)。42%的患者基本没有TMD体征,7.8%主要表现为触诊时肌肉压痛,36.3%有伴或不伴有颞下颌关节压痛的关节弹响,13.7%有肌肉-关节联合体征。任何头影测量变量与颅下颌指数、功能障碍指数和肌肉指数评分之间均无令人信服的相关性。该患者群体中的一个30人的亚组在手术前正畸治疗期间及治疗前均接受了评估。颅下颌指数、功能障碍指数或肌肉指数评分未发现有统计学意义的变化。因此,这些患者的正畸治疗期似乎并未增加TMD的发生概率。