颞下颌关节病变与主诉之间关系的回顾性研究

A. A. Marfina, E. P. Voloshina, A. A. Molgachev
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The criterion for inclusion in the study was the presence of a newly diagnosed disease of the temporomandibular joint, mandatory radiological diagnostic methods. Magnetic resonance imaging (MRI) of the TMJ in the patient who sought medical help was used as a radiation diagnosis. As part of the scientific study, the structure of pathological changes in the TMJ was analyzed, the relationship between the presence of complaints and the revealed pathology was studied.Results. The analysis of the data showed that the MR examination of the TMJ reveals pathological changes in patients who sought orthodontic care, both with complaints and with an asymptomatic course of diseases. Data analysis did not show a statistically significant relationship between the presence of complaints and the revealed pathology in the case of degenerative (χ2 = 0.123; p > 0.05), inflammatory changes in the TMJ (χ2 = 0.123; p > 0.05) and pathological disorders of the masticatory muscles (F = 0.704; p > 0.05). 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引用次数: 0

摘要

简介。在口腔正畸医生的临床实践中,颞下颌关节(TMJ)疾病因其广泛多样的临床表现而成为一个亟待解决的问题。研究已确定的颞下颌关节解剖和功能障碍与颞下颌关节病理改变结构中存在的特征性主诉之间的关系,这些关系是正畸治疗期间出现并发症的风险因素。根据组织类型和数据收集时间比例,该科学研究属于纵向回顾性研究,根据观察类型:病例对照。研究对 102 名在牙科诊所寻求正畸医生帮助的患者的门诊病历进行了回顾性分析。纳入研究的标准是存在新诊断的颞下颌关节疾病,必须采用放射诊断方法。就医患者的颞下颌关节磁共振成像(MRI)被用作放射诊断。作为科学研究的一部分,对颞下颌关节的病理变化结构进行了分析,并研究了存在主诉与所显示病理之间的关系。数据分析显示,颞下颌关节磁共振检查显示,在寻求正畸治疗的患者中,无论是有主诉还是无症状病程的患者,都会出现病理变化。数据分析显示,在颞下颌关节退行性病变(χ2 = 0.123;P > 0.05)、颞下颌关节炎症性病变(χ2 = 0.123;P > 0.05)和咀嚼肌病理紊乱(F = 0.704;P > 0.05)的病例中,主诉的存在与所显示的病理变化之间没有显著的统计学关系。腹侧脱位未复位(p < 0.05;φ = 0.107)和椎间盘背侧排列(p < 0.05;φ = 0.101)在统计学上有意义,但关系较弱。在关节盘腹侧脱位与复位的情况下,两者之间的关系具有统计学意义,属于中等强度(p < 0.05;φ = 0.284)。对医疗文件的回顾性分析结果证实,在确定正畸干预的最佳策略阶段,无论患者是否有任何主诉,都有必要对所有患者采用工具性研究方法,以获得有关颞下颌关节状况的诊断信息,从而预防正畸治疗期间并发症的风险。
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A retrospective study of the relationship between the presence of complaints and the identified pathological changes in the temporomandibular joint
Introduction. In the practice of an orthodontist, diseases of the temporomandibular joint (TMJ) are an urgent problem due to their widespread, diverse clinical manifestations.Goal. To study the relationship between the identified anatomical and functional disorders of the TMJ, as risk factors for complications during orthodontic treatment, and the presence of characteristic complaints in the structure of pathological changes in the TMJ.Materials and methods. According to the type of organization and the ratio of data collection time, the scientific study belonged to a longitudinal retrospective study, according to the type of observation: case-control. A retrospective analysis of 102 outpatient medical records of patients who sought medical help from an orthodontist at a dental clinic was carried out. The criterion for inclusion in the study was the presence of a newly diagnosed disease of the temporomandibular joint, mandatory radiological diagnostic methods. Magnetic resonance imaging (MRI) of the TMJ in the patient who sought medical help was used as a radiation diagnosis. As part of the scientific study, the structure of pathological changes in the TMJ was analyzed, the relationship between the presence of complaints and the revealed pathology was studied.Results. The analysis of the data showed that the MR examination of the TMJ reveals pathological changes in patients who sought orthodontic care, both with complaints and with an asymptomatic course of diseases. Data analysis did not show a statistically significant relationship between the presence of complaints and the revealed pathology in the case of degenerative (χ2 = 0.123; p > 0.05), inflammatory changes in the TMJ (χ2 = 0.123; p > 0.05) and pathological disorders of the masticatory muscles (F = 0.704; p > 0.05). The relationship is statistically significant, but weak for ventral dislocation without reposition (p < 0.05; φ = 0.107) and the dorsal arrangement of the disc (p < 0.05; φ = 0.101). In the case of ventral dislocation of the articular disc with the reposition, the relationship is statistically significant, of medium strength (p < 0.05; φ = 0.284).Conclusions. The results of a retrospective analysis of medical documentation confirm the need for instrumental research methods for all patients, regardless of whether they have any complaints at the stage of determining the optimal tactics of orthodontic intervention to obtain diagnostic information on the state of the TMJ in order to prevent the risks of complications during orthodontic treatment.
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