1. 天津市口腔医院正畸科,天津,300041
2. 天津市功能重建重点实验室,天津,300041
3. 呼和浩特市口腔医院正畸二科,呼和浩特,010030
4. 南开大学医学院,天津,300071
5. 山西白求恩医院口腔科,太原,030000
6. 中国医科大学口腔医学院,沈阳,110122
Published:2023,
Published Online:20 March 2023,
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ZHANG Chunxiang, JIN Jing, ZHI Cheng, et al. Dynamic occlusal characteristics and differences in adult patients with TMD in different jaw positions. [J]. Journal of Southwest Medical University 46(2):162-166(2023)
ZHANG Chunxiang, JIN Jing, ZHI Cheng, et al. Dynamic occlusal characteristics and differences in adult patients with TMD in different jaw positions. [J]. Journal of Southwest Medical University 46(2):162-166(2023) DOI: 10.3969/j.issn.2096-3351.2023.02.015.
目的利用T-scan 数字化电子咬合分析系统来记载伴颞下颌关节紊乱病(temperomandibular disorders,TMD)病人在进行动态咬合时的接触,并分析当下颌由不同颌位起始开始运动时的咬合特征以及时间特点,以此来探究下颌运动时的咬合特征及其与TMD 的相关性。方法选择40 例18~30 岁成人作为研究对象,根据DC/TMD 诊断标准将其分为对照组(n = 17)和TMD 组(n = 23)。通过T-scan 分别记录受试者由牙尖交错位(intercuspal position,ICP)和参考位置(reference position,RP)起始的咬合过程,记录下颌运动时间指标以及ICP 最大咬合时测量指标。结果TMD 组由RP 开始下颌运动的时间较由ICP 开始的时间长,并且左侧方咬合分离时间、右侧方咬合分离时间的差异具有统计学意义(P < 0.05)。相较于对照组,TMD 组在由RP 起始运动时,左右两侧的侧方咬合分离时间差异均有统计学意义(P < 0.05);当下颌由牙尖交错位开始运动时,前伸咬合分离时间的差异具有统计学意义(P < 0.05)。与对照组相比,TMD 组的左右侧力值比差值、COF 横向偏移量以及COF 平均偏移距离均较大,差异均具有统计学意义(P < 0.05)。结论当成年病人存在TMD 时,由RP 和ICP 起始的下颌运动均会存在时间差异。另外,伴TMD 成年病人在咬合时,相较于那些无TMD 症状的病人,左右侧的咬合力分布会更加不均衡。
Objective The T-scan digital electronic occlusion analysis system was used for recording the dynamic occlusal contact of patients with TMD and analysing the occlusal characteristics and temporal characteristics of their jaw movements in different jaw positions to investigate the correlation between occlusal characteristics and TMD during jaw movements. Methods Forty adults aged 18-30 years were selected as study subjects and divided into control group (N = 17) and TMD group (N = 23) according to the DC/TMD diagnostic criteria. The subjects’occlusal processes initiated by ICP (intercuspal position,ICP) and RP (reference position,RP) were recorded by T-scan separately,and the mandibular movement time index as well as the ICP measurement at maximum occlusion were recorded. Results The TMD group had longer mandibular movement times initiated by RP than by ICP,with significant differences (P < 0.05) in left lateral occlusal separation time and right lateral occlusal separation time. Compared to the control group,the TMD group had significant differences (P < 0.05) in left and right lateral occlusal separation time when the mandible was moved from RP initiation. When the mandible began to move from the apical position,the difference in the separation time of the anterior extension occlusion was statistically significant (P < 0.05). Compared with the control group,TMD group had larger ratio difference of left and right side force value,COF lateral offset and mean COF offset distance,and the differences were statistically significant (P < 0.05). Conclusion There were differences in the timing of mandibular movements initiated by RP and ICP respectively in adults with TMD; the distributions of occlusal forces between the right and left sides were more disequilibrium in adults with TMD than those without TMD .
咬合颞下颌关节紊乱病颞下颌关节牙尖交错位参考位置
OcclusionTMDTMJICPReference Position
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