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目的探讨颞下颌关节紊乱病(TMD)发病情况及相关致病因素分析。方法于2009年4-10月选择内蒙古自治区牧区蒙古族人群817人和城市汉族居民1006人为调查对象,利用颞下颌关节(TMJ)功能问卷和TMD临床检查相结合的方法进行流行病学研究。调查问卷包括受调查者身体状况、TMJ既往功能状况以及精神因素;临床检查包括下颌边缘运动、关节功能、咀嚼肌疼痛及牙齿缺失、修复情况。结果蒙古族人群的TMD发病率远低于汉族人群(P<0.05);临床检查发现蒙古族人群和汉族人群在最大开口度,前伸、侧方最大运动距离差异无统计学意义(P>0.05)。在TMD的可能致病因素中,蒙古族人群咬合力大于汉族人群(P<0.05)。在牙齿缺失及修复方面蒙古族人群的后牙缺失后修复率明显低于汉族人群(P<0.05);蒙古族人群的肘、膝关节的疼痛发生率高于汉族人群(P<0.05)。蒙古族人群存在心理问题明显低于汉族人群(P<0.05)。结论心理因素对于TMD的发生有决定性作用。
Objective To investigate the incidence of temporomandibular disorder (TMD) and its related risk factors. METHODS: From April to October 2009, 817 Mongolians and 1006 Han residents in the pastoral areas of Inner Mongolia Autonomous Region were enrolled in this study. Epidemiological studies were conducted using the TMJ functional questionnaire and TMD clinical examination. The questionnaire included the physical status of the respondents, the previous functional status of TMJ, and the mental factors. The clinical examinations included mandibular edge movement, joint function, masticatory muscle pain and tooth loss and repair. Results The incidence of TMD in Mongolian population was much lower than that in Han population (P <0.05). There was no significant difference in the maximal opening degree, anterior extension and lateral maximal movement distance between Mongolian and Han nationalities (P> 0.05) ). Among the possible pathogenetic factors of TMD, the occlusal force of Mongolian population was greater than that of Han population (P <0.05). The recovery rate of posterior teeth missing in Mongolian population was significantly lower than that in Han population (P <0.05). The incidence of elbow and knee pain in Mongolian population was higher than that in Han population (P <0.05). The psychological problems in Mongolian population were significantly lower than those in Han population (P <0.05). Conclusion Psychological factors play a decisive role in the occurrence of TMD.