Abstract:

Objective    To investigate the relationship between the depth of curve of Spee（COS） and temporomandibular joint disorders（TMD） in elderly patients. Methods    Eighty-nine elderly patients with TMD visiting the Hospital of Stomatology of China Medical University from January 2013 to June 2013 were recruited in the study by random number table. Muscle pain and temporomandibular joint（TMJ）sounds were examined according to Research Diagnostic Criteria for TMD，and the depth of COS were measured on the dental casts. The mean depth of COS of patients without muscle pain and patients with pain at all levels were compared，and the unilateral depth of COS of patients with and without TMJ sounds were compared. Related data were analyzed statistically with one-way analysis of variance and t-test. Results           The depth of ipsilateral COS of patients with TMJ sounds was significantly smaller than those of patients without TMJ sounds（left：P < 0.001；right：P = 0.008），while the depth of contralateral COS of patients with TMJ sounds had no significant differences with those of patients without TMJ sounds（left：P = 0.481；right：P = 0.905）. In addition，there were no significant differences between the mean depth of COS of patients without muscle pain and patients with pain at all levels（P = 0.327）. Conclusion    TMJ sounds are closely associated with COS，and the depth of ipsilateral COS of patients with TMJ sounds is smaller，and the COS is flatter. There is no significant association between the mean depth of COS and muscle pain.

Key words: temporomandibular joint disorders, temporomandibular joint, occlusion, curve of Spee

摘要：

目的    分析中老年患者Spee曲线深度特点与颞下颌关节紊乱病（temporomandibular joint disorders，TMD）症状之间的关系。方法    采用随机数字表法从2013年1—7月于中国医科大学附属口腔医院就诊的中老年TMD患者中选取89例，根据TMD研究诊断标准对患者肌肉疼痛与关节弹响症状进行检查，并通过研究模型测量患者Spee曲线深度。比较无肌肉疼痛及各级肌肉疼痛症状患者Spee曲线平均深度以及有无关节弹响症状患者的两侧Spee曲线深度，分别采用单因素方差分析与t检验进行统计分析。结果    有关节弹响症状患者的弹响关节同侧Spee曲线深度小于无关节弹响患者该侧Spee曲线深度，差异有统计学意义（左侧：P < 0.001；右侧：P = 0.008）；而弹响关节对侧Spee曲线深度与无弹响患者相比，差异无统计学意义（左侧：P = 0.481；右侧：P = 0.905）。无肌肉疼痛及轻、中、重度肌肉疼痛症状的患者Spee曲线平均深度相比较，差异均无统计学意义（P = 0.327）。结论            TMD关节弹响症状与Spee曲线关系密切，伴有关节弹响的TMD患者的弹响关节同侧Spee曲线深度较小，形态较为平坦。而TMD肌肉疼痛症状与Spee曲线的深度并无明显相关性。

关键词: 颞下颌关节紊乱病, 颞下颌关节, 牙合, Spee曲线