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

[1]	Sharawy M, Ali AM, Choi WS, et al. Ultrastructural characterization of the rabbit mandibular condyle following experimental induction of anterior disk displacement[J]. Cells Tissues Organs, 2000, 167(1):38-48. pmid: 10899715
[2]	Sharawy M, Ali AM, Choi WS. Experimental induction of anterior disk displacement of the rabbit craniomandibular joint: An immuno-electron microscopic study of collagen and proteogly can occurrence in the condylar cartilage[J]. J Oral Pathol Med, 2003, 32(3):176-184. doi: 10.1034/j.1600-0714.2003.00074.x
[3]	Dijkgraaf LC, de Bont LG, Boering G, et al. The structure, biochemistry, and metabolism of osteoarthritic cartilage: A review of the literature[J]. J Oral Maxillofac Surg, 1995, 53(10):1182-1192. doi: 10.1016/0278-2391(95)90632-0
[4]	Wilkes CH. Internal derangements of the temporomandibular joint. pathological variations[J]. Arch Otolaryngol Head Neck Surg, 1989, 115(4):469-477. doi: 10.1001/archotol.1989.01860280067019
[5]	Schiffman EL, Ahmad M, Hollender L, et al. Longitudinal stability of common TMJ structural disorders[J]. J Dent Res, 2017, 96(3):270-276. doi: 10.1177/0022034516679396 pmid: 27856966
[6]	Li CX, Liu X, Gong ZC, et al. Morphologic analysis of condyle among different disc status in the temporomandibular joints by three-dimensional reconstructive imaging: A preliminary study[J]. BMC Oral Health, 2022, 22(1):395. doi: 10.1186/s12903-022-02438-1
[7]	Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic criteria for temporomandibular disorders(DC/TMD)for clinical and research applications: Recommendations of the international RDC/TMD consortium network^* and orofacial pain special interest group[J]. J Oral Facial Pain Headache, 2014, 28(1):6-27. doi: 10.11607/jop.1151
[8]	Liu SS, Xu LL, Lu SJ, et al. Diagnostic performance of magnetic resonance imaging for degenerative temporomandibular joint disease[J]. J Oral Rehabil, 2023, 50(1):24-30. doi: 10.1111/joor.v50.1
[9]	傅开元, 胡敏, 余强, 等. 颞下颌关节常规MRI检查规范及关节盘移位诊断标准的专家共识[J]. 中华口腔医学杂志, 2020, 55(9):608-612.
[10]	dos Anjos Pontual ML, Freire JSL, Barbosa JMN, et al. Evalua-tion of bone changes in the temporomandibular joint using cone beam CT[J]. Dentomaxillofac Radiol, 2012, 41(1):24-29. doi: 10.1259/dmfr/17815139
[11]	Massilla Mani F, Sivasubramanian SS. A study of temporomandibular joint osteoarthritis using computed tomographic imaging[J]. Biomed J, 2016, 39(3):201-206. doi: 10.1016/j.bj.2016.06.003 pmid: 27621122
[12]	Dias IM, de F Cordeiro PC, Devito KL, et al. Evaluation of temporomandibular joint disc displacement as a risk factor for osteoarthrosis[J]. Int J Oral Maxillofac Surg, 2016, 45(3):313-317. doi: 10.1016/j.ijom.2015.09.016
[13]	Fan PD, Xiong X, Cheng QY, et al. Risk estimation of degenerative joint disease in temporomandibular disorder patients with different types of sagittal and coronal disc displacements: MRI and CBCT analysis[J]. J Oral Rehabil, 2023, 50(1):12-23. doi: 10.1111/joor.v50.1
[14]	Moncada G, Cortés D, Millas R, et al. Relationship between disk position and degenerative bone changes in temporomandibular joints of young subjects with TMD. An MRI study[J]. J Clin Pediatr Dent, 2014, 38(3):269-276. doi: 10.17796/jcpd.38.3.w43m8474433n7ur2 pmid: 25095324
[15]	Kalladka M, Quek S, Heir G, et al. Temporomandibular joint osteoarthritis: Diagnosis and long-term conservative management: A topic review[J]. J Indian Prosthodont Soc, 2014, 14(1):6-15. doi: 10.1007/s13191-013-0321-3
[16]	Lei J, Han JH, Liu MQ, et al. Degenerative temporomandibular joint changes associated with recent-onset disc displacement without reduction in adolescents and young adults[J]. J Craniomaxillofac Surg, 2017, 45(3):408-413. doi: S1010-5182(16)30339-0 pmid: 28108240
[17]	Manfredini D, Segù M, Arveda N, et al. Temporomandibular joint disorders in patients with different facial morphology. A systematic review of the literature[J]. J Oral Maxillofac Surg, 2016, 74(1):29-46. doi: 10.1016/j.joms.2015.07.006
[18]	Cortés D, Exss E, Marholz C, et al. Association between disk position and degenerative bone changes of the temporomandibular joints: An imaging study in subjects with TMD[J]. Cranio, 2011, 29(2):117-126. doi: 10.1179/crn.2011.020 pmid: 21661586
[19]	Dias IM, Coelho PR, Picorelli Assis NM, et al. Evaluation of the correlation between disc displacements and degenerative bone changes of the temporomandibular joint by means of magnetic resonance images[J]. Int J Oral Maxillofac Surg, 2012, 41(9):1051-1057. doi: 10.1016/j.ijom.2012.03.005
[20]	Liu YS, Yap AUJ, Lei J, et al. Association between hypoplastic condyles and temporomandibular joint disc displacements: A cone beam computed tomography and magnetic resonance imaging metrical analysis[J]. Int J Oral Maxillofac Surg, 2020, 49(7):932-939.
[21]	Guarda Nardini L, Meneghini M, Guido M, et al. Histopathology of the temporomandibular joint disc: Findings in 30 samples from joints with degenerative disease[J]. J Oral Rehabil, 2021, 48(9):1025-1034. doi: 10.1111/joor.v48.9
[22]	Emshoff R, Bertram A, Hupp L, et al. A logistic analysis prediction model of TMJ condylar erosion in patients with TMJ arthralgia[J]. BMC Oral Health, 2021, 21(1):374. doi: 10.1186/s12903-021-01687-w pmid: 34303363
[23]	Krisjane Z, Urtane I, Krumina G, et al. The prevalence of TMJ osteoarthritis in asymptomatic patients with dentofacial deformities: A cone-beam CT study[J]. Int J Oral Maxillofac Surg, 2012, 41(6):690-695.

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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