下颌第三磨牙阻生病人发生颞下颌关节紊乱病的危险因素分析  

Risk factors of temporomandibular disordersin patients with mandibular third molar impaction

作　　者：程鑫[1] 张国强 CHENG Xin;ZHANG Guoqiang(Hefei Stomatological College of Anhui Medical University,Hefei Stomatological Hospital,Hefei Anhui 230000,China)

机构地区：[1]安徽医科大学合肥口腔临床学院,安徽省合肥市口腔医院,安徽合肥230000

出　　处：《蚌埠医学院学报》2024年第3期358-361,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨下颌第三磨牙阻生病人发生颞下颌关节紊乱病(TMD)的危险因素,并建立相关风险列线图模型。方法:选取下颌第三磨牙阻生病人209例,根据TMD发生情况,分为TMD组54例和非TMD组155例,采用单因素分析和多因素logistic回归分析方法对TMD风险因素进行分析,并据此建立列线图预测模型。结果:单因素分析显示,2组病人性别、Pell-Gregory分类、偏侧咀嚼和SAS评分间差异均有统计学意义(P<0.05~P<0.01)。多因素logistic回归分析显示,女性、Ⅲ类阻生、低位阻生、偏侧咀嚼和SAS评分≥50分均为下颌第三磨牙阻生病人发生TMD的独立危险因素(P<0.05~P<0.01)。依此建立TMD风险列线图模型,验证显示一致性指数为0.745,校准曲线趋近于理想曲线,ROC曲线下面积为0.753(95%CI:0.714~0.792),10%~75%范围内列线图净获益。结论:女性、Ⅲ类阻生、低位阻生、偏侧咀嚼和SAS评分≥50分增加下颌第三磨牙阻生病人TMD风险,据此构建列线图模型,能有效预测下颌第三磨牙阻生病人TMD发生风险。Objective:To explore the risk factors of temporomandibular disorders(TMD)in patients with mandibular third molar impaction,and to establish a risk nomogram model.Methods:A total of 209 patients with mandibular third molar impaction were selected and divided into TMD group(n=54)and non-TMD group(n=155)based on the occurrence of TMD.Univariate analysis and multivariate logistic regression analysis were used to analyze the risk factors of TMD,and a nomogram prediction model was established.Results:Univariate analysis showed that there were significant differences in gender,Pell-Gregory classification,unilateral mastication,and SAS scores between the two groups(P<0.05 to P<0.01).Multivariate logistic regression analysis showed that female,typeⅢimpaction,low impaction,unilateral mastication and SAS scores more than 50 points were independent risk factors for TMD in patients with mandibular third molar impaction(P<0.05 to P<0.01).Based on this,a TMD risk nomogram model was established.The model verification results showed that the C-index was 0.745,the calibration curve was almost the ideal curve,the area under the ROC curve was 0.753(95%CI:0.714-0.792),and the nomogram had a net benefit of 10%-75%.Conclusions:Female,typeⅢimpaction,low impaction,unilateral mastication and SAS scores more than 50 points increase the risk of TMD in patients with mandibular third molar impaction.Nomogram model based on this can effectively predict the risk probability of TMD in patients with mandibular third molar impaction.

关 键 词：颞下颌关节紊乱病 下颌第三磨牙阻生 列线图模型 

分 类 号：R782.6[医药卫生—口腔医学]