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目的探讨成人正畸治疗对颞颌关节(temporomandibular joint,TMJ)的影响及其与颞下颌关节紊乱病(temporomandibular disorder TMD)的关系。方法选择60名20～29岁成人正畸患者,用Helkimo指数将患者分为TMJ无症状组、TMJ有症状组两组,分别在治疗前(t1)、治疗中期(t2)及治疗结束后(t3),用MRI检查治疗前后关节盘的位置,并用电子测量尺测量TMJ的前、后间隙,观察颞颌关节在治疗前后的变化情况与TMD之间的关系。结果 TMJ无症状组、TMJ有症状组在治疗中TMD的发生率分别为18.20%、56.25%,差异有显著性(P<0.05),并发现关节盘移位,治疗后关节前间隙增加,关节后间隙减少。结论成人正畸治疗不会导致TMD,但在治疗过程中可能出现TMD症状,并有出现TMD重度症状的风险。成人在正畸治疗前对TMJ进行评估有重要意义。
Objective To investigate the effect of orthodontic treatment on temporomandibular joint (TMJ) in adults and its relationship with temporomandibular disorder (TMD). Methods Sixty adult orthodontic patients aged 20 to 29 years old were selected. Patients were divided into TMJ asymptomatic group and TMJ symptomatic group with Helkimo index before treatment (t1), after treatment (t2) and after treatment ( t3). The position of the disc before and after treatment was examined by MRI, and the anterior and posterior gap of TMJ was measured by electronic measuring ruler. The relationship between TMJ and temporomandibular joint was observed before and after treatment. Results In TMJ asymptomatic group, the incidences of TMD in TMJ symptomatic group were 18.20% and 56.25%, respectively, with significant difference (P <0.05), and found that the articular disc displacement, the anterior joint space increased after treatment, After the gap reduction. Conclusion Adult orthodontic treatment does not cause TMD, but TMD symptoms may occur during treatment and there is a risk of developing severe TMD symptoms. It is important for adults to evaluate TMJ before orthodontic treatment.