稳定型咬合板治疗不同类型颞下颌关节紊乱的效果探究

doi:10.13591/j.cnki.kqyx.2025.12.007

摘要/Abstract

摘要：

目的本研究旨在探讨针对不同类型颞下颌关节紊乱(temporomandibular joint disorders,TMD)患者采用稳定型咬合板进行治疗的疗效。方法选取2021年1月至2024年1月在徐州医科大学附属口腔医院进行治疗的颞下颌关节紊乱患者,按不同类型分为两组:肌源性组和关节源性组。两组患者均接受稳定型咬合板治疗,并在治疗开始后第1、2、3个月进行复诊。通过评估颞下颌功能评分、咬合力度分布平衡度、咬合时间、咬合分离时间、疼痛指数、张口度等指标,比较两组患者的治疗效果。统计分析采用t检验。结果治疗前,肌源性组与关节源性组在颞下颌功能评分、咬合力度分布平衡度、咬合时间、咬合分离时间、疼痛评分、张口度等指标之间无显著差异(P>0.05)。然而,经过治疗后,两组患者的各项指标均得到改善,与治疗前相比具有统计学意义(P<0.05)。关节源性组在治疗后的颞下颌功能评分、咬合力度分布平衡度、咬合时间、咬合分离时间、疼痛评分和张口度均显著优于肌源性组(P<0.05)。结论稳定型咬合板治疗TMD效果显著,且对关节源性TMD的治疗效果更为突出。此外,该治疗方法简单,安全,可靠。

关键词: 稳定型咬合板, 颞下颌关节紊乱病, 肌源性, 关节源性

Abstract:

Objective To explore the effectiveness of stable occlusal splints in treating different types of temporomandibular joint disorders. Methods Patients with temporomandibular disorders who were treated in Affiliated Stomatological Hospital of Xuzhou Medical University from January 2021 to January 2024 were divided into two groups, myogenic group and arthrogenic group. The patients in both groups were treated with stable occlusal splint and were followed up at 1, 2, and 3 months after treatment.The temporomandibular function score, occlusal force distribution balance degree, occlusal time, occlusal separation time, pain index and mouth opening degree were evaluated and compared between the two groups. Statistical analysis was conducted using the t-test. Results Before treatment, there were no significant differences in temporomandibular function score, balance of occlusal force distribution, occlusal time, occlusal separation time, pain score, mouth-opening degree between the muscular group and the articular group(P>0.05). After treatment, temporomandibular function score, occlusal force distribution balance, occlusal time, occlusal separation time, pain score and mouth opening degree were improved in both groups compared with before treatment, and there were significant differences(P<0.05). Moreover, the temporomandibular function score, balance degree of occlusal force distribution, occlusal time, occlusal separation time, pain score and mouth opening degree of the arthrogenic group were significantly better than those of the musculogenic group after treatment(P<0.05). Conclusion The stabilization splint is effective in the treatment of TMD, and it is more effective in the treatment of articular TMD. The method is simple, safe and reliable.

Key words: stable occlusal splint, temporomandibular joint disorders, myogenic, arthrogenic

中图分类号:

R782.6

冯妍, 许岗, 王阳阳, 唐娜, 张婷. 稳定型咬合板治疗不同类型颞下颌关节紊乱的效果探究[J]. 口腔医学, 2025, 45(12): 918-922.

FENG Yan, XU Gang, WANG Yangyang, TANG Na, ZHANG Ting. Study on the effect of stable occlusal splint on the treatment of different types of temporomandibular joint disorders[J]. Stomatology, 2025, 45(12): 918-922.

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时间点	肌源性组				关节源性组
时间点	运动	关节杂音	关节处压诊	肌肉压诊	运动	关节杂音	关节处压诊	肌肉压诊
治疗前	12.11±2.37	13.82±2.65	4.22±0.75	13.21±2.28	12.15±2.39	13.65±2.66	4.26±0.68	13.16±2.31
治疗1个月	9.18±1.53^b	9.13±1.67^b	3.56±0.45^b	8.56±1.52^b	8.66±1.56^ab	8.32±1.12^ab	3.31±0.46^ab	8.65±1.58^ab
治疗2个月	6.39±1.23^bcd	6.11±0.97^bcd	2.62±0.33^bcd	6.26±1.29^bcd	5.02±1.16^abcd	5.33±0.86^abcd	5.37±1.26^abcd	6.11±0.96^abcd
治疗3个月	5.13±0.63^bcd	5.53±1.28^bcd	1.55±0.21^bcd	4.36±0.67^bcd	4.26±0.56^abcd	4.12±0.28^abcd	4.33±0.59^abcd	4.14±0.68^abcd

时间点	肌源性组			关节源性组
时间点	力度分布平衡度/%	咬合时间/s	咬合分离时间/s	力度分布平衡度/%	咬合时间/s	咬合分离时间/s
治疗前	19.23±1.11	0.99±0.33	1.23±0.26	19.28±1.09	0.98±0.31	1.22±0.23
治疗1个月	20.32±1.82^b	0.86±0.32^b	1.08±0.26^b	21.33±1.79^ab	0.79±0.31^ab	1.00±0.21^ab
治疗2个月	24.26±1.63^bc	0.78±0.28^bc	0.99±0.35^bc	25.73±1.61a^bc	0.70±0.25a^bc	0.91±0.33^abc
治疗3个月	26.38±1.35^bc	0.66±0.28^bc	0.90±0.41^bc	29.36±1.65^abc	0.55±0.25^abc	0.80±0.36^abc

时间点	肌源性	关节源性	t	P
治疗前	8.50±1.38	8.52±1.36	0.988	0.653
治疗1个月	7.56±1.51	6.52±1.55	3.212	0.032
治疗2个月	5.23±1.29	4.35±1.32	3.523	0.029
治疗3个月	3.35±0.89	2.32±0.99	3.662	0.021

时间点	肌源性	关节源性	t	P
治疗前	27.53±3.78	27.33±3.99	0.965	0.668
治疗1个月	28.55±3.93	29.65±4.12	4.231	0.019
治疗2个月	31.63±3.63	32.33±3.29	4.643	0.015
治疗3个月	33.23±3.53	36.32±3.21	4.993	0.011