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安氏Ⅱ类错(牙合)正中关系位-最大牙尖交错位位移与颞下颌关节紊乱症的相关性研究
The Relationship Between Centric Relation-Maximum Intercuspation Disharmony and Temporomandibular Dysfunction in Class Ⅱ Patients
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摘要: 目的 横向调查安氏Ⅱ类错(牙合)畸形正畸初诊人群正中关系位-最大牙尖交错位(CR-MI)的位移程度与颞下颌关节紊乱病(TMD)之间的相关性,为制定临床治疗计划提供参考。 方法 选取符合纳入标准的安氏Ⅱ类错(牙合)患者107例。对所有受检者进行TMD症状、体征及相关情况的专科检查和问卷调查,所得结果用Helkimo指数[临床功能紊乱指数(Di)、既往功能紊乱指数(Ai)]进行分析。受检者正中关系位(CR)与最大牙尖交错位(MI)在三维方向上的差异用髁突位置测量仪(Condyle Position Indication,CPI)记录及测量。 结果 所有受检者Di与5个方向、Ai与4个方向(除横向偏斜)上的CR-MI位移量呈正相关(P<0.05),且Di、Ai与CR-MI不调数量也呈正相关(P<0.05),CR-MI位移量及CR-MI不调量随着Di、Ai等级的增加而增加;除横向偏斜外,TMD症状和体征均与其它4个方向的CR-MI位移量呈正相关(P<0.05),与CR-MI不调数量也呈正相关(P<0.05),有TMD症状和体征的患者其CR-MI位移量及CR-MI不调数量明显增加。 结论 CR-MI的位移程度是TMD发生的重要因素,并与TMD症状及体征的严重程度呈正相关。Abstract: Objective To investigate the relationship between the degree of displacement of centric relation--maximum intercuspation (CR-MI) and temporomandibular dysfunction (TMD) in Class Ⅱ patients. Methods The questionnaire and clinical examination were administered in 107 Class Ⅱ patients and students, using the Helkimo index (Di and Ai). The differences in condylar position between CR and MI in all three spatial planes were measured using the Condyle Position Indication (CPI). Results Di positively correlated with degree of CR-MI displacement in all five displacement (P<0.05), while Ai positively correlated with degree of CR-MI displacement except horizontal displacement. Di and Ai significantly correlated with degree of CR-MI discrepancy in all five displacement (P<0.05); With the increasing of Di and Ai rank, the degree of CR-MI displacement and CR-MI discrepancy increased. Also, symptoms of TMD were significantly correlated with the degree of CR-MI displacement and CR-MI discrepancy except horizontal displacement (P<0.05). Severer CR-MI displacement and CR-MI discrepancy were observed in patients who had TMD symptoms. Conclusion In Class Ⅱ patients, degree of CR-MI displacement is an important factor of TMD, and correlated with the severity of TMD.
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