咬合异常与颞下颌关节紊乱症的关系再思考  

Reevaluation of the association between the malocclusion and temporomandibular disorders

作　　者：朱锦怡 龚衍吉 郑芳杰 于世宾 尹德强[2] 刘洋[1] ZHU Jinyi;GONG Yanji;ZHENG Fangjie;YU Shibin;YIN Deqiang;LIU Yang(National Center for Stomatology&National Clinical Research Center for Oral Diseases,Department of Temporomandibular Joint,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]国家口腔医学中心,国家口腔疾病临床医学研究中心,四川大学华西口腔医院颞下颌关节科,四川成都610041 [2]重庆大学航空航天学院,重庆400044 [3]国家口腔疾病临床医学研究中心,陕西省口腔疾病国际联合研究中心,空军军医大学第三附属医院解剖生理学教研室,陕西西安710032

出　　处：《口腔医学》2024年第1期24-30,共7页Stomatology

基　　金：四川省自然科学基金项目(2023NSFSC0568);四川大学华西口腔交叉学科创新项目(RD⁃03⁃202005);四川大学华西口腔医院临床医学研究项目(LCYJ2023⁃YF⁃3)。

摘　　要：咬合异常与颞下颌关节紊乱症(temporomandibular disorders,TMD)之间的关系一直备受争议。过去的研究通过观察性和干预性临床研究、动物实验、机制研究以及三维有限元模拟技术等手段,试图揭示二者之间的相关性。然而,研究结果存在较大分歧,使得这种关系迄今仍不够清晰。最近的研究重新考察了此前的研究结果,发现静态的咬合异常与TMD关系确实不够明确。但牙列和髁突之间的相对位置关系对关节的生物力学性能和功能状态都有明显影响,这为我们深入理解和治疗TMD提供了新的思路和方向。尽管咬合异常与TMD之间的关系还需进一步研究以得到明确的证实,但对牙列和髁突之间相对位置的影响机制的研究可能有助于更好地理解TMD,并为其诊断和治疗提供更有效的方式。The contribution of malocclusion to temporomandibular disorders(TMD)has been a subject of ongoing debate.Many ob⁃servational and interventional clinical studies,animal experiments,mechanical studies,and three dimensional finite element simulations have been conducted to investigate this relationship.However,significant discrepancies among research findings have made it challenging to establish a clear understanding.Based on previous findings,it is believed that while there may be some potential associa⁃tions,malocclusion is not considered a primary etiological factor for TMD.Although further research is required to confirm the association between malocclusion and TMD,it is still noteworthy that the positional relationship between the dentition and the condyle may po⁃tentially affect the biomechanical and functional status of the joints.The purpose of this article is to provide a review of current research and offer our interpretation of this topic,presenting new perspectives and approaches for understanding and treating TMD.

关 键 词：颞下颌关节紊乱症 咬合异常 临床研究 三维有限元模拟 髁突相对牙合平面的高度 

分 类 号：R782.63[医药卫生—口腔医学]