正畸干预前后MIC-CR位髁突位移变化

doi:10.6040/j.issn.1671-7554.0.2014.447

摘要/Abstract

摘要： 目的旨在探讨正畸干预对最大牙尖交错位(MIC)-正中关系位(CR)髁突位移量的影响.方法选取16~45岁门诊正畸患者31例,其中非颞下颌关节紊乱病(TMD)组16例(NTMD组),TMD组15例,在正畸干预前后分别取MIC与CR位记录.分析两组患者正畸干预前后正中牙合位与正中关系位的髁突位置差异.结果正畸干预前TMD组与NTMD组MIC-CR之间髁突位移(MCD)量存在差异,正畸干预后两组MIC-CR位移量减小,TMD组较为显著,且多为有利变化,TMD组正畸干预前后MIC-CR髁突位移量与TMD症状自评量表得分呈相关性.结论正畸干预在一定程度上对错牙合畸形患者的髁突位置产生影响,对于TMD患者尤甚.因此,正畸医生要认识并注意到错牙合畸形对TMD产生和发展的作用,并正确认识MCD在诊断中的局限性.

关键词: 最大牙尖交错位, 颞下颌关节紊乱病, 正畸, 正中关系, 髁突位移

Abstract: Objective To investigate the effects of orthodontic intervention on maximum intercuspation (MIC)- centric relation (CR) condylar displacement of patients with or without temporomandibular disorders (TMD). Methods A total of 31 orthodontic patients aged 16 to 45 years were selected and divided into the TMD group (n=15) and non-TMD group (n=16). Records of MIC and CR of these patients taken before and after orthodontic intervention were compared. Results The two groups had different MIC-CR displacement before and after treatment. There were more changes in the TMD group, and the changes were mostly favorable. The MIC-CR condylar displacement was correlated with the symptom checklist (SCL) score. Conclusion Orthodontic intervention has effect on condylar position of patients, especially for those with TMD. Orthodontists, therefore, need to understand and pay attention to the effect of malocclusion on TMD and limitations of measurement of condylar displacement (MCD) in the diagnosis.

Key words: Orthodontics, Maximum intercuspation, Centric relation, Measurement of condylar displacement, Temporomandibular disorders

中图分类号:

R783.5

韩旭, 邵玉婷, 孙钦凤, 郭泾. 正畸干预前后MIC-CR位髁突位移变化[J]. 山东大学学报（医学版）, 2015, 53(8): 61-65.

HAN Xu, SHAO Yuting, SUN Qinfeng, GUO Jing. Different condylar displacements between centric relation and maximum intercuspation before and after orthodontic intervention[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(8): 61-65.

参考文献

[1] 陈扬熙. 口腔正畸学—基础、技术与临床[M]. 北京:人民卫生出版社, 2012:122.
[2] Tarantola GJ, Becker IM, Gremillion H. The reproducibility of centric relation:a clinical approach[J]. J Am Dent Assoc, 1997, 128(9):1245-1251.
[3] Giradot RA. Goal-directed orthodontics[M]. America: RWISO, 2013:651-671.
[4] Iven Klineberg. Rob Jagger. Occlusion and clinical practice—An evidence-based approach[M]. London: ELSEVIER Limited, 2004: 55-67.
[5] Tripodakis AP, Smulow JB, Mehta NR, et al. Clinical study of location and reproducibility of three mandibular positions in relation to body posture and muscle function[J]. J Prosthet Dent, 1995, 73(2):190-198.
[6] Giradot RA. Goal-directed orthodontics[M]. America: RWISO, 2013: 9-182.
[7] Dawson PE. New definition for relating occlusion to varying conditions of the temporomandibular joint[J]. J Prosth Dent, 1995, 74(6):619-627.
[8] Karl PJ, Foley TF. The use of a deprogramming appliance to obtain centric relation records[J]. Angle Orthod, 1999, 69(2):117-125.
[9] Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique[J]. J Craniomandib Disord, 1992, 6(4):301-355.
[10] Cordray FE. Three-dimensional analysis of models articulated in the seated condylar position from a deprogrammed asymptomatic population:a prospective study. Part 1[J]. Am J Orthod Dentofacial Orthop, 2006, 129(5):619-630.
[11] 季尚华. 颞下颌关节紊乱病的流行病学调查及其治疗的研究[D]. 青岛:青岛大学, 2003.
[12] Helkimo M. Studies on function and dysfunction of the masticatory system. I. An epidemiological investigation of symptoms of dysfunction in Lapps in the north of Finland[J]. Proc Finn Dent Soc, 1974, 70(2):37-49.
[13] Solberg WK, Woo MW, Houston JB. Prevalence of mandibular dysfunction in young adults[J]. J Am Dent Assoc, 1979, 98(1):25-34.
[14] 韩科, 张豪. 牙合学—理论与临床实践[M]. 北京:人民军医出版社, 2008:159-161.
[15] Egermark I, Magnusson T, Carlsson GE. A 20-year follow-up of signs and symptoms of temporomandibular disorders and malocclusions in subjects with and without orthodontic treatment in childhood[J]. Angle Orthod, 2003, 73(2):109-115.
[16] Mohlin BO, Derweduwen K, Pilley R, et al. Malocclusion and temporomandibular disorder:a comparison of adolescents with moderate to severe dysfunction with those without signs and symptoms of temporomandibular disorder and their further development to 30 years of age[J]. Angle Orthod, 2004, 74(3):319-327.
[17] Fujii T. Occlusal conditions just after the relief of temporomandibular joint and masticatory muscle pain[J]. J Oral Rehabil, 2002, 29(4):323-329.
[18] Celi R, Jerolimov V. Association of horizontal and vertical overlap with prevalence of temporomandibular disorders[J]. J Oral Rehabil, 2002, 29(6):588-593.
[19] Johnston LE Jr. Gnathologic assessment of centric slides in postretention orthodontic the patients[J]. J Prosthet Dent, 1988, 60(6):712-715.
[20] Klar NA, Kulbersh R, Freeland T, et al. Maximum intercuspation-centric relation disharmony in 200 consecutively finished cases in a gnathologically oriented practice[J]. Sem Orthod, 2003, 9(2):109-116.
[21] 周佳卉, 白丁, 井岩, 等. 安氏Ⅱ类错牙合正畸结束患者髁突位置的初步研究[J]. 四川大学学报:医学版, 2010, 41(5):849-853. ZHOU Jiahui, BAI Ding, Jing Yan, et al. Condylar Position of Post orthodontic Patients with ClassⅡ Malocclusion[J]. J Sichuan Univ:Med Sci Edi, 2010, 41(5):849-853.
[22] Van Blarcom CW. Glossary of prosthodontics. 6th edition[J]. J Prosthet Dent, 1994, 71(2):43-104.
[23] Crawford SD. Condylar axis position, as determined by the occlusion and measured by the CPI instrument, and signs and symptoms of temporomandibular dysfunction[J]. Angle Orthod, 1999, 69(2):103-114.
[24] Kruger DM, Dale BG. Analysis and correction of condylar displacement of the TMJ[J]. JPD, 1982, 47:646-653.
[25] 王云霁, 陈嵩, 石安田, 等. 安氏Ⅱ类错牙合正中关系位-最大牙尖交错位位移与颞下颌关节紊乱症的相关性研究[J]. 四川大学学报:医学版, 2013, 44(2):231-236. WANG Yunji, CHEN Song, SHI Antian, et al. The relationship between centric relation-maximum intercuspation disharmony and temporomandibular dysfunction in Class Ⅱ patients[J]. J Sichuan Univ: Med Sci Edi, 2013, 44(2):231-236.
[26] Weffort SY, de Fantini SM. Condylar displacement between centric relation and maximum intercuspation in symptomatic and asymptomatic individuals[J]. Angle Orthod, 2010, 80(5):835-842.

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