成人正畸患者颞下颌关节紊乱病临床分析.docVIP

成人正畸患者颞下颌关节紊乱病临床分析 　　[摘要] 目的 探讨成人正畸治疗对TMD相关症状体征的影响，为成人患者个性化正畸治疗提供参考。方法 方便选择2010年8月―2012年8月在该院口腔科接受正畸治疗的成年患者132例，根据治疗过程中拔牙情况分成非拔牙组、拔除4颗前磨牙组和非对称性拔牙组。以Helkimo临床症状指数作为评价标准，评价治疗过程中、治疗后1年和治疗后2年患者TMD相关情况，并进行评分，评估他们之间的关系。 结果 非拔牙组、拔除4颗前磨牙组和非对称性拔牙组治疗中分别有8、7和9例患者发生TMD，治疗后1年和两年3组发生TMD患者数分别为4和2，3和2及4和3。3组手术后Helkimo临床症状指数分别为（2.8±2.9），（2.3±2.6）和（2.9±3.0），术后两年分别为（1.3±2.0），（1.2±1.9）和（1.3±2.1），手术后两年均较术后指数分值明显改善，但手术后和术后两年组间差异无统计学意义（P0.05）。 结论 成人正畸治疗与TMD发生没有明显关系，是否拔牙及拔牙方式不会影响TMD的发生，但正畸治疗的过程中有可能会出现TMD症状体征 [关键词] 正畸治疗；颞下颌关节紊乱病；Helkimo指数 [中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）04（a）-0063-04 Clinical Analysis of Temporomandibular Joint Disorder in Adult Orthodontic Patients WU Yuan-yuan Department of Stomatology， Nanjing Mingji Hospital， Nanjing， Jiangsu Province， 210019 China [Abstract] Objective To study the effect of adult orthodontic treatment on the TMD related symptoms and body signs and provide reference for the individual orthodontic treatment of adult patients. Methods 132 cases of adult patients receiving the orthodontic treatment in our hospital from August 2010 to August 2012 were conveniently selected and divided into non-extraction group， four premolars extraction group and nonsymmetrical extraction group according to the teeth extraction situations and the Helkimo clinical symptoms index was used as the evaluation standards， the TMD related situations in the treatment course， 1-year after treatment and 2-year after treatment were evaluated and the correlation between them was evaluated. Results TMD respectively occurred to 8， 7 and 9 cases in the three groups， and TMD respectively occurred to 4 and 2， 3 and 2 and 4 and 3 in 1-year and 3-year after treatment， and the Helkimo clinical symptoms indexes after operation were respectively（2.8±2.9），（2.3±2.6） and （2.9±3.0） and （1.3±2.0），（1.2±1.9） and （1.3±2.1） in 2 years after operation， which were obviously improved compared with the postoperative indexes， but there was no obvious difference after operation and i