“手术优先”正畸正颌治疗对于颞下颌关节紊乱症的影响

›› 2017, Vol. 37 ›› Issue (12): 1079-1082.

“手术优先”正畸正颌治疗对于颞下颌关节紊乱症的影响

王小旻¹,李琥²,陈文静³,吕冬⁴

1. 常州市儿童医院口腔科
2. 南京医科大学口腔疾病研究江苏省重点实验室
3. 江苏省口腔医院
4. 南京市中西医结合医院

收稿日期:2017-04-18 修回日期:2017-05-16 出版日期:2017-12-28 发布日期:2017-12-28
通讯作者: 吕冬 E-mail:2251597665@qq.com
基金资助:
江苏高校优势学科建设工程资助项目

The effect of surgery first orthodontics for symptoms of temporomandibular dysfunction

Xiaomin WANG¹,

Received:2017-04-18 Revised:2017-05-16 Online:2017-12-28 Published:2017-12-28

摘要/Abstract

摘要： 目的：评估“手术优先”正畸正颌治疗对于颞下颌关节紊乱综合症的治疗效果方法：本研究回顾性分析2013-2015年就诊于南京医科大学附属口腔医院正畸科及外科的患者共计43例，均采用“手术优先”正颌正畸治疗。分别对其颞下颌关节紊乱综合症进行自身的评估以及客观的分析。对于颞下颌关节症状的描述分为三个不同的阶段：T1：一般为术前一周到两周，T2：术后两周到三周即术后正畸开始前，T3：整个治疗过程结束，一般为术后10个月到一年左右。对所得数据进行统计分析，P＜0.05代表有统计学意义。结果：女性患者TMD发病率较男性高，所有患者治疗后TMD人数（32.6%）低于治疗前（79%）。合平面偏斜超过2mm患者患有TMD概率明显高于偏斜小于2mm的患者（P=0.009）。有TMD及无TMD患者中均存在T1到T2阶段最大张口度明显变小（P<0.001），T2到T3阶段明显增大（P<0.001），T1与T3阶段无明显变化（P>0.05）的情况。双颌手术或下颌单颌的手术方式对各阶段最大张口度均无明显影响。结论：“手术优先”正颌正畸治疗方法在改善骨性错颌患者面部外形及咬合的基础上，能够缓解合并有颞下颌关节紊乱症患者的关节症状。

关键词: 牙颌面畸形，手术优先正颌正畸，颞下颌关节紊乱

Abstract: Objective：To evaluate the influence of surgery first orthodontic treatment for temporomandibular disorder(TMD) Methods: 43 patients who had undergone surgery first orthognathic treatment at Affiliated Stomatological Hospital of Nanjing Medical University between 2013 and 2015 were studied. The symptoms of TMD were assessed subjectively and objectively in three different periods: one or two weeks before surgery (T1),two or three weeks after surgery(T2), after postoperativeorthodontics(T3).Statistical analysis were performed to verify the association of the variables(P<.05). Results: When compared to males females had a higher prevalence of TMD(P=0.014). There was a decrease in TMD between T1 and T3. Patients with occlusal plane deviation over 2mm also had a higher prevalence of TMD(P=0.009). Maximum mouth opening(MMO) with TMD decreased from T1 to T2(P<.001), improved from T1 to T3(P<.001) and no different between T1 and T3. The same situation occurred in MMO without TMD.There was no statistical significant different between mandible surgery and combined jaws surgery. Conclusions: The signs and symptoms of patients with TMDs can be relived under treatment of surgery first orthodontic.

Key words: Dento-maxilloficial deformities，Surgery first orthodontics，Temporomandibular disorders

中图分类号:

R783.5

王小旻李琥陈文静吕冬. “手术优先”正畸正颌治疗对于颞下颌关节紊乱症的影响[J]. , 2017, 37(12): 1079-1082.

Xiaomin WANG. The effect of surgery first orthodontics for symptoms of temporomandibular dysfunction[J]. , 2017, 37(12): 1079-1082.

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