中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (5): 443-448.doi: 10.19438/j.cjoms.2022.05.005

• 论著 • 上一篇    下一篇

青少年颞下颌关节盘前移位患者就诊情况分析

张大河, 沈佩, 杨驰   

  1. 上海交通大学医学院附属第九人民医院 口腔外科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海 200011
  • 收稿日期:2022-04-23 修回日期:2022-05-28 出版日期:2022-09-20 发布日期:2022-09-20
  • 通讯作者: 杨驰,E-mail：yangchi63@hotmail.com
  • 作者简介:张大河(1998-),男,博士研究生,E-mail：zdh8328@sjtu.edu.cn
  • 基金资助:
    国家自然科学基金 (81870785,82071134); 上海交通大学医学院附属第九人民医院优势疾病生物样本项目 (YBKA201908)

Characteristics of adolescent patients with temporomandibular joint anterior disc displacement

ZHANG Da-he, SHEN Pei, YANG Chi   

  1. Department of Oral Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China
  • Received:2022-04-23 Revised:2022-05-28 Online:2022-09-20 Published:2022-09-20

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摘要： 目的: 总结颞下颌关节 (temporomandibular joint,TMJ) 盘前移位 (anterior disc displacement,ADD) 就诊患者特征。方法: 纳入2015年4月至2018年11月初次就诊于上海交通大学医学院附属第九人民医院口腔外科并诊断为TMJ ADD的连续病例。收集患者人口统计学信息、首诊科室、主诉、现病史、既往史、临床检查、辅助检查结果和诊断等资料,采用SPSS 21.0软件包对数据进行统计学分析。结果: 研究期间共纳入743例ADD患者,男女比例为1∶5.52。其中20岁以下的患者比率最高 (58.0%),就诊高峰年龄为15~16岁。年龄 ≤ 20岁的青少年患者与成年患者相比,因牙颌面畸形主诉而首诊于正畸 (或正颌) 科的患者占比更高 (P<0.001),有更高的夜磨牙患者占比 (P<0.001),而有耳前区疼痛、下颌偏斜症状或被诊断为特发性髁突吸收的患者占比较低 (P<0.01)。在年龄≤20岁的青少年患者中,因牙颌面畸形主诉而首诊于正畸 (或正颌) 科的患者与因关节相关问题首诊于关节专科的患者相比,有耳前区疼痛和开口受限症状的患者占比更低 (P<0.01),但下颌后缩患者占比更高 (P<0.001)。结论: 青少年TMJ ADD患者对该疾病有很高的治疗需求,其中相当一部分患者以牙颌面畸形为主诉、有更轻的关节症状,但不了解颞下颌关节问题和牙颌面畸形的密切关系,可能会贻误最佳治疗时机。

关键词: 颞下颌关节, 关节盘前移位, 牙颌面畸形, 特发性髁突吸收

Abstract: PURPOSE: To Summarize the characteristics of patients with temporomandibular joint (TMJ) anterior disc displacement (ADD) in our department. METHODS: Consecutive patients first diagnosed with TMJ ADD in the TMJ Clinic at Department of Oral Surgery in Shanghai Ninth People's Hospital from April 2015 to November 2018 were included in this study. Demographic information, first visit department, chief complaints, history of present illness, past history, clinical characteristics and diagnosis of the patients were collected. The data was analyzed by SPSS 21.0 software package. RESULTS: A total of 743 ADD patients were enrolled during the observation period, and the male to female ratio was 1:5.52. Among them, patients ≤20 years old accounted for the highest proportion (58.0%), and the peak age of the visited population was 15-16 years old. Compared with adult patients, adolescent patients ≤ 20 years old had a higher proportion of patients who first visited orthodontic (or orthognathic) department due to the chief complaint of dentofacial deformity (P<0.001), a higher proportion of patients with bruxism(P<0.001), and lower proportions of patients with preauricular pain, mandibular deviation or who were diagnosed as idiopathic condylar resorption (all P<0.01). In the adolescent patients ≤ 20 years, patients who first visited orthodontic (or orthognathic) department due to the chief complaint of dentofacial deformity had lower proportions of patients with preauricular pain or restricted mouth opening (P<0.01), and a higher proportion of patients with mandibular retraction(P<0.001). CONCLUSIONS: Adolescents with TMJ ADD have much higher demand for treatment than other age groups. A considerable number of them present the main complaint of dentofacial deformities and have milder symptoms, but they do not understand the relationship between TMJ diseases and dentofacial deformities, which might delay the best treatment opportunity.

Key words: Temporomandibular joint, Anterior disc displacement, Dentofacial deformity, Idiopathic condylar resorption

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