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目的:研究短牙弓患者颞下颌关节的负荷以及短牙弓与颞下颌关节紊乱的关联。方法:通过CT扫描获得头面部原始数据,建立三维有限元模型,比较完整牙弓和短牙弓的颞下颌关节应力和负荷;临床上收集短牙弓病例,根据患者的修复意愿分成两组(活动义齿RPD组和短牙弓SDA组),同时收集完整牙列的患者作为对照组(全牙弓CDA组),比较3组患者的颞下颌关节紊乱相关体征。结果:有限元分析发现随着牙弓的缩短,颞下颌关节应力和负荷增大;临床检查发现短牙弓组颞下颌关节紊乱体征的阳性率增加,但3组之间没有统计学差异。结论:短牙弓虽然不是颞下颌关节紊乱的危险因素,但是要关注短牙弓患者颞下颌关节的变化。
Objective: To study the relationship between temporomandibular joint load and short-toothed arch and temporomandibular joint disorders in short-toothed patients. Methods: The CT scans were used to obtain the raw data of head and face. The three-dimensional finite element model was established to compare the stress and load of temporomandibular joint between complete dental arch and short dental arch. The cases of short dental arch were collected clinically and divided into two groups according to the patients’ Denture RPD group and SDA group), while patients with intact dentition were selected as control group (all-arch CDA group). The patients with TMD-related signs were compared. Results: Finite element analysis showed that with the shortening of dental arch, stress and load of temporomandibular joint increased. The positive rate of temporomandibular joint dysfunction in short-toothed arch group was increased after clinical examination, but there was no statistical difference between the three groups. Conclusion: Although the short dental arch is not a risk factor of temporomandibular joint disorder, attention should be paid to the changes of temporomandibular joint in patients with short dental arch.