不同关节盘状态下的颞下颌关节紊乱病患者发生退行性关节病的风险评估分析

doi:10.13591/j.cnki.kqyx.2024.04.002

Abstract

Abstract:

Objective To investigate the risk and severity of degenerative joint diseases(DJD)in patients with temporomandibular disorder diseases(TMD) under different joint disc states. Methods A total of 156 temporomandibular joints in 78 TMD patients were divided into three groups based on MRI images: normal disc position, anterior disc displacement with reduction(ADDR) and anterior disc displacement without reduction(ADDNR). CBCT or CT images were used to diagnose DJD and assess the severity of condylar bone changes. The OR value of DJD under different joint disc states was estimated by Logistic regression, and the regression coefficient of the severity of condylar bone changes under different joint disc states was estimated by ordinary least square regression. Results Compared with the normal disc position, the OR value of DJD in ADDR group and ADDNR group were 4.652(P<0.001), 16.739(P<0.001), respectively. The regression coefficient for condylar erosion in the ADDR group was 0.646(P<0.001). The regression coefficients for condylar cysts, condylar erosion, condylar osteophytes, condylar flattening, condylar bone sclerosis of ADDNR group were 0.241(P<0.05), 1.486(P<0.001), 0.759(P<0.001), 0.566(P<0.001), 0.381(P<0.05). Conclusion ADDR and ADDNR are associated with the occurrence of DJD in TMD patients, and the risk of DJD is higher in ADDNR than in ADDR. The degree of condylar bone changes in ADDNR is more serious than that of ADDR.

Key words: temporomandibular joint disorder, CBCT, CT, MRI, degenerative joint disease

CLC Number:

R782.6

TAO Xingxing, WANG Jizhou, CHEN Peiyao, MA Siwei. Risk assessment and analysis of degenerative joint diseases in patients with temporomandibular disorder diseases under diffe-rent joint disc states[J]. Stomatology, 2024, 44(4): 245-249.

Figures/Tables 6

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References 23

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分组	非DJD	DJD	P
年龄组			0.7
≤18岁	20(28.2%)	26(30.6%)
>18岁	51(71.8%)	59(69.4%)
性别			0.5
女	50(70.4%)	64(75.3%)
男	21(29.6%)	21(24.7%)

关节盘状态	OR	OR的95%可信区间
正常关节盘状态vs.ADDR	4.652^***	[2.191,10.270]
正常关节盘状态vs.ADDNR	16.739^***	[5.199,75.634]

关节盘状态	囊变	骨质缺损	骨赘形成	髁突变平	骨质硬化
正常关节盘状态vs.ADDR
回归系数	0.122	0.646^***	0.170	0.168	0.137
95%可信区间	[-0.041,0.284]	[0.317,0.975]	[-0.120,0.460]	[-0.093,0.428]	[-0.113,0.387]
正常关节盘状态vs.ADDNR
回归系数	0.241^*	1.486^***	0.759^***	0.566^***	0.381^*
95%可信区间	[0.040,0.442]	[1.081,1.891]	[0.402,1.115]	[0.245,0.886]	[0.074,-0.689]

Risk assessment and analysis of degenerative joint diseases in patients with temporomandibular disorder diseases under diffe-rent joint disc states

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关节盘状态	非DJD	DJD	合计	P
正常关节盘位置	49(67.1%)	24(32.9%)	73	<0.001
ADDR	16(30.8%)	36(69.2%)	52
ADDNR	6(19.3%)	25(80.6%)	31
合计	71	85	156

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