上海口腔医学

上海口腔医学 ›› 2021, Vol. 30 ›› Issue (4): 439-443.doi: 10.19439/j.sjos.2021.04.020

• 论著 • 上一篇    下一篇

双颌前突患者正畸治疗后颞下颌关节紊乱病发生状况及危险因素分析

程洁1, 张栋1, 谢丽丽1, 王璞2, 李娟1, 郝玮1   

  1. 1.河北省人民医院 口腔科,河北 石家庄 050051;
    2.河北医科大学第二医院 口腔修复科,河北 石家庄 050000
  • 收稿日期:2020-12-04 修回日期:2021-01-05 出版日期:2021-08-25 发布日期:2021-09-23
  • 通讯作者: 程洁,E-mail:17675975@qq.com
  • 作者简介:程洁（1980-）,女,硕士研究生,主治医师

Incidence and risk factors of temporomandibular joint disorders in patients with bimaxillary protrusion after orthodontic treatment

CHENG Jie1, ZHANG Dong1, XIE Li-li1, WANG Pu2, LI Juan1, HAO Wei1   

  1. 1. Department of Stomatology, Hebei Provincial People's Hospital. Shijiazhuang 050051;
    2. Department of Prosthodontics, Second Hospital of Hebei Medical University. Shijiazhuang 050000, Hebei Province, China
  • Received:2020-12-04 Revised:2021-01-05 Online:2021-08-25 Published:2021-09-23

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摘要： 目的: 观察双颌前突患者经正畸治疗后颞下颌关节紊乱病（TMD）的发生情况,探讨造成这一现象的可能因素,以期指导TMD的合理预防。方法: 收集2019年3月—2020年10月于河北省人民医院接受正畸治疗的80例双颌前突患者的临床资料进行回顾性分析,参照相关文献判定方法,将其中正畸治疗后发生TMD的患者纳入实验组,其余患者纳入对照组,设计基线资料调查表,尽可能将影响双颌前突患者正畸治疗后发生TMD的高危因素纳入,经单因素、多因素分析后,找出双颌前突正畸治疗患者可能发生TMD的影响因素。采用SPSS 23.0软件包对数据进行统计学分析。结果: 80例双颌前突患者经正畸治疗后发生TMD 15例,占18.75%（15/80）;未发生TMD 65例,占81.25%（65/80）。分析2组基线资料后,将差异有统计学意义的变量进行单因素分析,然后将全部基线资料纳入,建立多元回归模型。结果显示,在校正其他基线资料带来的影响后,年龄、性别、压力知觉量表评分、口腔不良习惯、龋齿、颌面部外伤史、牙状况、饮食不良习惯、根管治疗史均是双颌前突患者正畸治疗后发生TMD的影响因素（OR>1,P<0.05）。结论: 双颌前突正畸治疗后发生TMD的风险因素可能与女性、年龄小、压力知觉评分高、合并口腔和饮食不良习惯、既往存在龋齿、根管治疗史及牙状况等密切相关,应加强年轻女性患者正畸治疗的科学性和规范性,宣传口腔健康知识,建立良好的饮食习惯。对既往存在根管治疗史、颌面部外伤史、龋齿等情况的正畸治疗患者应加强干预措施,对减少TMD发生具有积极意义。

关键词: 双颌前突, 正畸治疗, 颞下颌关节紊乱病, 危险因素

Abstract: PURPOSE: To observe the occurrence of temporomandibular joint disorder (TMD) in patients with bimaxillary protrusion after orthodontic treatment, and to explore the possible factors causing this phenomenon, so as to guide rational prevention of TMD in clinic. METHODS: The clinical data of 80 patients with bimaxillary protrusion who received orthodontic treatment in Hebei Provincial People's Hospital from March 2019 to October 2020 were retrospectively analyzed. The patients with TMD after orthodontic treatment were included in the experimental group and the remaining patients were included in control group. The baseline data questionnaire was designed for bimaxillary protrusion patients after orthodontic treatment. The risk factors of TMD were included in the study. Through a series of univariate and multivariate analysis, the influencing factors of TMD in patients with bimaxillary protrusion after orthodontic treatment were determined. SPSS 23.0 software package was used to analyze the data. RESULTS: Among 80 patients with bimaxillary protrusion after orthodontic treatment, 15(18.75%) were included in the experimental group, while 65(81.25%) did not have TMD, and were included in the control group. After a preliminary analysis of the baseline data, the variables with significant difference were included in the independent variables for univariate analysis. After adjusting for the influence of other baseline data, the results showed that younger age, girl, high stress perception scale score, bad oral habits, dental caries, history of maxillofacial trauma, bad eating habits, and root canal treatment history were the causes of bimaxillary protrusion. CONCLUSIONS: The risk factors of TMD of patients with bimaxillary protrusion after orthodontic treatment may be closely related to girl, younger age, high stress perception score, bad eating habits, previous caries, root canal treatment history and maxillofacial trauma. Therefore, it is necessary to strengthen the standardization of orthodontic treatment, publicize oral health awareness, establish good eating habits. Patients who had a history of root canal therapy, maxillofacial trauma and dental caries should be vigilant, which may be of positive significance in reducing the incidence of TMD.

Key words: Bimaxillary protrusion, Orthodontic treatment, Temporomandibular disorders, Risk factors

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