基于颞下颌关节思考成人安氏Ⅱ^(2)分类错[牙合]畸形的治疗  

Treatment of adult ClassⅡdivision 2 malocclusion based on temporomandibular joint

作　　者：李榕 赵青[1] Li Rong;Zhao Qing(State Key Laboratory of Oral Diseases&National Center for Stomatology&National Clinical Research Center for OralDiseases&Dept.of Orthodontics,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病防治全国重点实验室、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正畸科,成都610041

出　　处：《国际口腔医学杂志》2024年第6期687-698,共12页International Journal of Stomatology

基　　金：国家自然科学基金(82171003)。

摘　　要：安氏Ⅱ^(2)分类错[牙合]畸形以前牙内倾型深覆[牙合]、磨牙远中关系为特征,患者的前牙切导异常,导致下颌运动轨迹被迫后退。多数患者表现出下颌后缩,并伴有咀嚼肌疼痛、关节盘移位以及髁突位置异常等颞下颌关节紊乱症状。对于安氏Ⅱ^(2)分类的成人患者,正畸治疗和正畸正颌联合治疗主要是改善前牙舌倾、打开咬合以及协调上下牙列和颌骨的矢状向关系,但相关治疗措施对于颞下颌关节的影响尚有争议。本文综述了成人安氏Ⅱ^(2)分类患者的颞下颌关节特征、正畸治疗及正畸正颌联合治疗对颞下颌关节的影响,总结了有利于恢复正常盘-髁关系的咬合板治疗措施,以期能为成人安氏Ⅱ^(2)分类患者正畸治疗的临床诊断和方案设计提供参考,最终实现咬合和关节的协调、稳定。ClassⅡdivision 2 malocclusion is characterized by the distal occlusion of the first molars and a deep over-bite of the lingually inclined upper incisors.Abnormal incisal guidance leads to a retruded mandibular movement.Most patients exhibit a retruded mandible,accompanied with temporomandibular joint(TMJ)disorders,including masticatory muscle pain,disc displacement,and abnormal condylar positioning.For adult patients with ClassⅡdivision 2 malocclu-sion,orthodontic treatment and combined orthodontic-orthognathic treatment aim to correct deep overbite with an inward inclination and to coordinate the sagittal relationship of the upper and lower dental arches.However,the effect of these treatment measures on the TMJ remains unknown.In this study,the TMJ conditions,orthodontic treatment,combined orthodontic-orthognathic treatment,and the effects of these treatment measures in adult patients with ClassⅡdivision 2 malocclusion are reviewed.In addition,the occlusal splint treatment,which is conducive to restoring normal disc-condyle relationships,is summarized.This study aimed to provide reference for the clinical diagnosis and treatment planning of orthodontic treatment in adult ClassⅡdivision 2 patients,thereby achieving coordination and stability between occlusion and the TMJ.

关 键 词：安氏Ⅱ^(2)分类错[牙合]畸形 颞下颌关节紊乱病 关节盘前移位 正畸治疗 正畸正颌联合治疗 咬合板 

分 类 号：R783.5[医药卫生—口腔医学]