Pre-operative parafunctional or dysfunctional oral habits are associated with the temporomandibular disorders after orthognathic surgery: An observational cohort study
Pre-operative parafunctional or dysfunctional oral habits are associated with the temporomandibular disorders after orthognathic surgery: An observational cohort study
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DOI：
10.1111/joor.12749
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发表时间：
2019-04-01
影响因子：
2.9
通讯作者：
Nicot, Romain
中科院分区：
文献类型：
--
作者：
Bruguiere, Fanny;Sciote, James J.;Nicot, Romain
背景颞颌关节紊乱病(TMD)是一种常见的致残性疾病，因此，预防TMD是一个重要的健康问题。联合正畸和手术治疗错(牙合)会影响TMJ的健康。然而，关于预测正颌外科术后TMJ预后的危险因素的文献很少。目的开展前瞻性队列研究，以确定正颌外科手术后出现TMD症状与术前功能障碍/副功能口腔习惯之间的关系。方法在里尔大学口腔颌面外科接受正畸和外科手术治疗的237例患者中，所有患者均接受正畸治疗。通过临床检查记录患者手术前后的副功能和功能障碍口腔习惯以及TMD症状的出现情况。结果多因素分析显示磨牙症(OR)3.17[1.066；9.432]、舌间插位(OR 4.241[1.351；13.313])、原发吞咽(OR3.54[1.225；10.234])与术后有无肌痛症状显著相关。此外，口腔功能障碍的存在与术后关节盘移位和移位有关(OR 4.611[1.249；17.021])。结论磨牙症和口腔功能障碍也是正畸和手术联合治疗后出现TMD症状的危险因素。在正颌外科手术前治疗这些习惯应该有助于预防TMD。
BackgroundTemporomandibular disorders (TMDs) are frequent and disabling, and hence, preventing them is an important health issue. Combining orthodontic and surgical treatments for malocclusions has been shown to affect temporomandibular joint (TMJ) health. However, publications regarding the risk factors that predict negative TMJ outcomes after orthognathic surgery are scarce.ObjectivePresent prospective cohort study was conducted to identify an association between pre-operative dysfunctional/parafunctional oral habits and the presence of TMD symptoms after orthognathic surgery.MethodWe included 237 patients undergoing orthodontics and surgical treatment for malocclusions associated with dentofacial deformities within the Department of Oral and Maxillofacial Surgery of the University of Lille. Their parafunctional and dysfunctional oral habits were recorded through clinical examination along with the presence of TMD symptoms before and after the surgery. According to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) classification, the TMD symptoms studied were myalgia, arthralgia, disc displacement with or without reduction.ResultsMultivariate analysis revealed significant associations among bruxism (odds ratio [OR] 3.17 [1.066; 9.432]), lingual interposition (OR 4.241 [1.351; 13.313]), as well as primary swallowing (OR 3.54 [1.225; 10.234]) and the presence of postoperative symptoms of myalgia. Moreover, a significant association was observed between the presence of any dysfunctional oral habit and postoperative disc displacement with reduction (OR 4.611 [1.249; 17.021]).ConclusionBruxism and dysfunctional oral habits were shown to be risk factors for the presence of TMD symptoms also after combined orthodontic and surgical treatment. Treating such habits before orthognathic surgery should help prevent TMD.