年轻人尸检中与颞下颌关节改变相关的错颌合

W.K. Solberg D.D.S. M.S.D. , C.A. Bibb Ph.D.D.D.S. , B.B. Nordström , T.L. Hansson L.D.S.Odont. Dr.
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引用次数: 103

摘要

本研究的目的是确定可能与先前报道的颞下颌关节形态学结果相关的错颌合变量。在从96具尸体(年龄x = 26.4±6.8岁)中取出左侧TMJ之前,进行口内检查。评估角度分类、交叉咬合、复咬合和复喷。分析这些参数与以下TMJ特征的关系:髁突和颞骨的整体形状,重塑的大体和组织学证据,以及关节盘的位置。当结合年龄时,角II类和III类牙列与颞和髁状偏差(DIF)相关(P <0.05),更多II类牙列伴有颞下颌关节重构改变的组织学证据。交叉咬合与所有成分中DIF的存在增加有关(P <0.01)。前牙合与关节隆起的DIF有关(P <0.01)。深度复咬在髁突扁平、下颌窝开放、颞关节面前伸的人群中更为常见(P <0.05)。椎间盘内DIF患者超流异常更为明显(P <0.05);较大的上喷流与椎间盘移位有关(P <0.05)。综合考虑,异常复咬合和复喷与髁上更广泛的DIF有关(P <0.05)。总之,错牙合与颞下颌关节的形态学改变有关,特别是与年龄有关。这一证据支持这样一种观点,即长时间暴露于错颌可能与更广泛的颞下颌关节改变有关。
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Malocclusion associated with temporomandibular joint changes in young adults at autopsy

The purpose of this study was to identify variables of malocclusion that might be associated with previously reported temporomandibular joint morphologic findings. Before removing the left TMJ from each of 96 cadavers (age x = 26.4 ± 6.8 years), an intraoral examination was performed. Angle classification, crossbite, overbite, and overjet were evaluated. These parameters were analyzed with respect to their association with the following TMJ features: overall shape of the condyle and temporal bone, gross and histologic evidence of remodeling, and position of the articular disk. When combined with age, Angle Class II and III dentitions were associated with temporal and condylar deviation in form (DIF) (P < 0.05) and more Class II dentitions were accompanied by histologic evidence of remodeling changes in the TMJs. Crossbite was associated with increasing presence of DIF in all components (P < 0.01). Anterior crossbite was associated with DIF on the articular eminence (P < 0.01). Deep overbite was more common in persons with flat condyles, open mandibular fossae, and anterior extension of the temporal articular surfaces (P < 0.05). Abnormal overjet was more evident in those with DIF in the disk (P < 0.05); greater overjet was associated with disk displacement (P < 0.05). Considered together, abnormal overbite and overjet were associated with more extensive DIF on the condyle (P < 0.05). In conclusion, malocclusion was associated with morphologic changes in the TMJ, particularly when combined with age. This evidence supports the belief that longer exposure to malocclusion may be associated with more extensive TMJ changes.

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