颞下颌关节紊乱病患者临床特征与髁突骨质变化Logistic回归分析  

Logistic regression analysis of clinical features and condylar bone changes in patients with temporomandibular disorders

作　　者：秦晗 郭少雄 刘一帆 刘璐 史明月 于世宾 QIN Han;GUO Shaoxiong;LIU Yifan;LIU Lu;SHI Mingyue;YU Shibin(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi International Joint Research Center for Oral Diseases,Department of Oral Anatomy and Physiology,The Third Hospital Affiliated of Air Force Military Medical University,710032 Xi'an,China)

机构地区：[1]口颌系统重建与再生全国重点实验室,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口腔解剖生理学教研室,西安710032 [2]中国人民解放军第960医院

出　　处：《实用口腔医学杂志》2024年第2期241-246,共6页Journal of Practical Stomatology

基　　金：国家重点研发计划(编号:2023YFC3605600);国家口腔疾病临床医学研究中心重点课题(编号:LCA202014)。

摘　　要：目的:探讨颞下颌关节紊乱病患者髁突影像学改变与临床特征的关系。方法:用CBCT对453例TMD患者行颞下颌关节扫描,并采用logistic回归分析髁突骨质变化与临床特征的关系。结果:<18岁及有疼痛、张口受限的患者更易出现髁突骨质改变。髁突骨质正常组(320例)伴发磨牙症的几率高于髁突骨质改变组(133例)。单因素logistic回归分析,磨牙症OR值为0.550,疼痛OR值为1.844,张口受限OR值为2.024。多因素logistic回归分析,由于磨牙症因素的保护作用,疼痛OR值降至1.791,张口受限OR值降至1.847。结论:发育期及有疼痛、张口受限的TMD患者更易发生髁突骨质改变,磨牙症可能是TMD患者髁突骨质改变发生的保护性因素。Objective:To investigate the relationship between CBCT imaging changes of condyle and clinical features,and related risk factors in patients with temporomandibular disorders(TMD).Methods:453 patients with TMD were enrolled and underwent CBCT scan for bilateral temporomandibular joints(TMJ),3D reconstruction of the TMJs was analyzed.Logistic regression analysis was performed to investigate the relationship between condylar bone changes and TMD clinical features.Results:Patients<18 years old were more likely to have condylar bone changes than the adults.The symptoms of pain and restricted mouth opening were more likely to be detected in the condylar bone change group(n=133)than in the normal condylar bone group(n=320).The incidence of bruxism in the normal condylar bone group was higher than that in the condylar bone change group.Univariate logistic regression analysis showed that only bruxism(OR=0.550),pain(OR=1.844)and mouth restriction(OR=2.024)were included in the regression equation.Multivariate logistic regression analysis showed that,due to the protective effect of bruxism,the OR value of pain decreased from 1.844 to 1.791,and the OR value of mouth restriction decreased from 2.024 to 1.847.Conclusion:The condylar bone change in TMD patients more likely occur in puberty or patients with pain and restricted mouth opening.Bruxism may be a protective factor in the occurrence of condylar bone changes in TMD patients.

关 键 词：颞下颌关节紊乱 颞下颌关节 髁突 锥形束CT 磨牙症 

分 类 号：R782.6[医药卫生—口腔医学]