Sonnesen L, Bakke M, Solow B
Department of Orthodontics, School of Dentistry, University of Copenhagen, Denmark.
Eur J Orthod. 1998 Oct;20(5):543-59. doi: 10.1093/ejo/20.5.543.
The present study reports the prevalence of the various traits of malocclusion, as well as the occurrence of associations between malocclusion, and symptoms and signs of temporomandibular disorders (TMD) in children selected for orthodontic treatment by the new Danish procedure for screening the child population for severe malocclusions entailing health risks. The sample comprised 104 children (56 F, 48 M) aged 7-13. Malocclusion traits were recorded at the time of selection, symptoms and signs of TMD were recorded at recall. The most prevalent malocclusion traits were distal molar occlusion (Angle Class II; 72 per cent), crowding (57 per cent), extreme maxillary overjet (37 per cent) and deep bite (31 per cent). Agenesis or peg-shaped lateral teeth were observed in 14 per cent of the children. The most prevalent symptom of TMD was weekly headache (27 per cent); the most prevalent signs of TMD were tenderness in the anterior temporal, occipital, trapezius, and superficial and profound masseter muscles (39-34 per cent). Seven per cent of the children were referred for TMD treatment. The Danish TMD screening procedure was positive in 26 per cent, while 20 per cent had severe symptoms (Aill), and 30 per cent had moderate signs (Dill) according to Helkimo (1974). Symptoms and signs of TMD were significantly associated with distal molar occlusion, extreme maxillary overjet, open bite, unilateral crossbite, midline displacement, and errors of tooth formation. The analysis suggests that there is a higher risk of children with severe malocclusions developing TMD. Errors of tooth formation in the form of agenesis or peg-shaped lateral teeth showed the largest number of associations with symptoms and signs of TMD; these associations have not previously been reported in the literature.
本研究报告了错牙合畸形各种特征的患病率，以及通过丹麦新的筛查程序选取的、因严重错牙合畸形而存在健康风险的正畸治疗儿童中，错牙合畸形与颞下颌关节紊乱病（TMD）症状和体征之间关联的发生率。样本包括104名7至13岁的儿童（56名女性，48名男性）。在入选时记录错牙合畸形特征，在随访时记录TMD的症状和体征。最常见的错牙合畸形特征是远中磨牙关系（安氏II类；72%）、牙列拥挤（57%）、上颌前突过大（37%）和深覆牙合（31%）。14%的儿童存在恒牙缺失或锥形侧切牙。TMD最常见的症状是每周头痛（27%）；TMD最常见的体征是颞前、枕、斜方肌以及表浅和深层咬肌压痛（39% - 34%）。7%的儿童被转诊接受TMD治疗。根据Helkimo（1974年）的标准，丹麦TMD筛查程序阳性率为26%，20%有严重症状（Aill），30%有中度体征（Dill）。TMD的症状和体征与远中磨牙关系、上颌前突过大、开牙合、单侧反牙合、中线移位以及牙齿形态异常显著相关。分析表明，严重错牙合畸形儿童患TMD的风险更高。恒牙缺失或锥形侧切牙形式的牙齿形态异常与TMD症状和体征的关联数量最多；这些关联此前在文献中未见报道。
