正畸治疗与颞下颌关节问题的研究进展
Research Progress of Problems of Temporomandibular Joint in Orthodontic Treatment
DOI: 10.12677/acm.2025.1541081, PDF,    科研立项经费支持
作者: 陈佳懿：浙江大学医学院附属第二医院综合牙科，浙江 杭州；浙江大学口腔医学院，浙江 杭州；章燕珍*：浙江大学医学院附属第二医院综合牙科，浙江 杭州
关键词: 正畸治疗；颞下颌关节；咬合；颞下颌关节紊乱病；Orthodontic Treatment； Temporomandibular Joint； Occlusion； Temporomandibular Disorders
摘要: 正畸治疗作为改善牙齿排列和咬合关系的重要手段，其与颞下颌关节(Temporomandibular joint, TMJ)健康之间的关联备受关注。然而，包括咬合不良能否引发颞下颌关节紊乱病(Temporomandibular disorders, TMD)、正畸治疗能否治疗TMD、正畸治疗是否增加TMD的发生率、伴TMJ症状和体征的患者能否进行正畸治疗等相关问题目前仍处于长期争议中。本文就正畸治疗相关的TMJ问题做一综述，阐释目前咬合不良和正畸治疗与TMD之间的相关性的研究现状，并为正畸治疗中应对关节问题的考量提供依据。
Abstract: As an important means to improve tooth alignment and occlusal relationship, orthodontic treatment has drawn much attention for its association with temporomandibular joint (TMJ) health. However, issues such as whether malocclusion can cause temporomandibular disorders (TMD), whether orthodontic treatment can treat TMD, whether orthodontic treatment increases the incidence of TMD, and whether patients with TMJ symptoms and signs can undergo orthodontic treatment remain in long-term controversy. This article reviews risks of TMJ in orthodontic treatment and explains the current research status of the correlation between malocclusion, orthodontic treatment and TMD, in order to provide a basis for considering joint issues in orthodontic treatment.
文章引用：陈佳懿, 章燕珍. 正畸治疗与颞下颌关节问题的研究进展[J]. 临床医学进展, 2025, 15(4): 1473-1478. https://doi.org/10.12677/acm.2025.1541081

参考文献

[1] Schiffman, E., Ohrbach, R., Truelove, E., Look, J., Anderson, G., Goulet, J., et al. (2014) Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. Journal of Oral & Facial Pain and Headache, 28, 6-27. [Google Scholar] [CrossRef] [PubMed]
[2] Valesan, L.F., Da-Cas, C.D., Réus, J.C., Denardin, A.C.S., Garanhani, R.R., Bonotto, D., et al. (2021) Prevalence of Temporomandibular Joint Disorders: A Systematic Review and Meta-analysis. Clinical Oral Investigations, 25, 441-453. [Google Scholar] [CrossRef] [PubMed]
[3] Li, D.T.S. and Leung, Y.Y. (2021) Temporomandibular Disorders: Current Concepts and Controversies in Diagnosis and Management. Diagnostics, 11, Article 459. [Google Scholar] [CrossRef] [PubMed]
[4] Shroff, B. (2018) Malocclusion as a Cause for Temporomandibular Disorders and Orthodontics as a Treatment. Oral and Maxillofacial Surgery Clinics of North America, 30, 299-302. [Google Scholar] [CrossRef] [PubMed]
[5] Michelotti, A., Rongo, R., D’Antò, V. and Bucci, R. (2020) Occlusion, Orthodontics, and Temporomandibular Disorders: Cutting Edge of the Current Evidence. Journal of the World Federation of Orthodontists, 9, S15-S18. [Google Scholar] [CrossRef] [PubMed]
[6] Myllymäki, E., Heikinheimo, K., Suominen, A., Evälahti, M., Michelotti, A., Svedström‐Oristo, A., et al. (2023) Longitudinal Trends in Temporomandibular Joint Disorder Symptoms, the Impact of Malocclusion and Orthodontic Treatment: A 20‐year Prospective Study. Journal of Oral Rehabilitation, 50, 739-745. [Google Scholar] [CrossRef] [PubMed]
[7] Olliver, S.J., Broadbent, J.M., Thomson, W.M. and Farella, M. (2020) Occlusal Features and TMJ Clicking: A 30-Year Evaluation from a Cohort Study. Journal of Dental Research, 99, 1245-1251. [Google Scholar] [CrossRef] [PubMed]
[8] Kandasamy, S., Rinchuse, D.J., Greene, C.S. and Johnston, L.E. (2022) Temporomandibular Disorders and Orthodontics: What Have We Learned from 1992-2022? American Journal of Orthodontics and Dentofacial Orthopedics, 161, 769-774. [Google Scholar] [CrossRef] [PubMed]
[9] Manfredini, D., Lombardo, L. and Siciliani, G. (2017) Temporomandibular Disorders and Dental Occlusion. A Systematic Review of Association Studies: End of an Era? Journal of Oral Rehabilitation, 44, 908-923. [Google Scholar] [CrossRef] [PubMed]
[10] Al-Khatieeb, M.M., Nissan, L.M., Al-Labban, Y.R. and Abid, M. (2024) Occlusal Features and Temporomandibular Joint Disorder: A Cross‐Sectional Study. International Journal of Dentistry, 2024, Article ID: 8715166. [Google Scholar] [CrossRef] [PubMed]
[11] 高博韬, 刘奕. 正畸联合多学科治疗颞下颌关节紊乱病的研究进展[J]. 中国实用口腔科杂志, 2023, 16(4): 398-401.
[12] Thomas, D.C., Singer, S.R. and Markman, S. (2023) Temporomandibular Disorders and Dental Occlusion: What Do We Know So Far? Dental Clinics of North America, 67, 299-308. [Google Scholar] [CrossRef] [PubMed]
[13] 杨驰. 颞下颌关节盘前移位与髁突骨吸收的关系及联合诊疗模式的探索[J]. 中华口腔医学杂志, 2017, 52(3): 157-160.
[14] Yap, A.U., Zhang, X., Cao, Y. and Fu, K. (2021) Functional, Physical and Psychosocial Impact of Degenerative Temporomandibular Joint Disease. Journal of Oral Rehabilitation, 49, 301-308. [Google Scholar] [CrossRef] [PubMed]
[15] de Kanter, R.J.A.M., Battistuzzi, P.G.F.C.M. and Truin, G. (2018) Temporomandibular Disorders: “Occlusion” Matters! Pain Research and Management, 2018, Article ID: 8746858. [Google Scholar] [CrossRef] [PubMed]
[16] Leite, R.A., Rodrigues, J.F., Sakima, M.T. and Sakima, T. (2013) Relationship between Temporomandibular Disorders and Orthodontic Treatment: A Literature Review. Dental Press Journal of Orthodontics, 18, 150-157. [Google Scholar] [CrossRef] [PubMed]
[17] Ortega, A., Pozza, D., Rodrigues, L. and Guimarães, A. (2016) Relationship between Orthodontics and Temporomandibular Disorders: A Prospective Study. Journal of Oral & Facial Pain and Headache, 30, 134-138. [Google Scholar] [CrossRef] [PubMed]
[18] Kandasamy, S. and Greene, C.S. (2020) The Evolution of Temporomandibular Disorders: A Shift from Experience to Evidence. Journal of Oral Pathology & Medicine, 49, 461-469. [Google Scholar] [CrossRef] [PubMed]
[19] Shalish, M., Leibovich, A., Zakuto, A., Slutzky, H., Chaushu, S. and Almoznino, G. (2023) The Association between Orthodontic Treatment and Temporomandibular Disorders Diagnosis and Disease Characteristics. Journal of Oral Rehabilitation, 51, 487-499. [Google Scholar] [CrossRef] [PubMed]
[20] Rustia, S., Lam, J., Tahir, P., Kharafi, L.A., Oberoi, S. and Ganguly, R. (2022) Three-dimensional Morphologic Changes in the Temporomandibular Joint in Asymptomatic Patients Who Undergo Orthodontic Treatment: A Systematic Review. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 134, 397-406. [Google Scholar] [CrossRef] [PubMed]
[21] Al-Somairi, M.A.A., Zheng, B., Yang, X., Zhang, Y., Alhammadi, M.S., xu, H., et al. (2025) Three-Dimensional Quantitative Temporomandibular Joint Changes in Skeletal Class I Malocclusion Treated with Extraction and Non-Extraction Protocols: A Comparative Study of Fixed Orthodontic Appliances and Clear Aligners. Progress in Orthodontics, 26, Article No. 4. [Google Scholar] [CrossRef] [PubMed]
[22] Liu, J., Wan, Y., Xie, T., Miao, T., Wang, J. and Xiong, X. (2022) Associations among Orthodontic History, Psychological Status, and Temporomandibular-Related Quality of Life: A Cross-Sectional Study. International Journal of Clinical Practice, 2022, Article ID: 3840882. [Google Scholar] [CrossRef] [PubMed]
[23] Thomas, D.C., Briss, D., Rossouw, P.E. and Iyer, S. (2023) Temporomandibular Disorders: Implications in Restorative Dentistry and Orthodontics. Dental Clinics of North America, 67, 309-321. [Google Scholar] [CrossRef] [PubMed]
[24] Pradhan, D., Almalki, S.A., Sharma, R., Mishra, S., Pathak, A., Jethlia, A., et al. (2024) Exploring the Impact of Orthodontic Treatment on Temporomandibular Joint Health. Journal of Pharmacy and Bioallied Sciences, 16, S2146-S2148. [Google Scholar] [CrossRef] [PubMed]
[25] Maurya, R.K., Singh, H., Talwar, B., Sharm, P. and Kapoor, P. (2022) Biometric Assessment of Temporomandibular Disorders in Orthodontics: A Multi-Arm Randomized Controlled Trial. Turkish Journal of Orthodontics, 35, 290-306. [Google Scholar] [CrossRef] [PubMed]
[26] Ehrmann, E., Bernabeu, M., Tillier, Y., Camia, J., Ecalle, C., Savoldelli, C., et al. (2024) Impact of Orthodontic-Surgical Treatments on the Signs and Symptoms of Temporomandibular Disorders: A Systematic Review. Dentistry Journal, 12, Article 132. [Google Scholar] [CrossRef] [PubMed]
[27] Singh, B.P., Singh, N., Jayaraman, S., Kirubakaran, R., Joseph, S., Muthu, M.S., et al. (2024) Occlusal Interventions for Managing Temporomandibular Disorders. Cochrane Database of Systematic Reviews, 9, CD012850. [Google Scholar] [CrossRef] [PubMed]
[28] Hudson, J.M. (2023) Regarding Recommendations for Temporomandibular Disorder and Orthodontics. American Journal of Orthodontics and Dentofacial Orthopedics, 163, 3-4. [Google Scholar] [CrossRef] [PubMed]
[29] Wieczorek, A., Loster, J. and Loster, B.W. (2013) Relationship between Occlusal Force Distribution and the Activity of Masseter and Anterior Temporalis Muscles in Asymptomatic Young Adults. BioMed Research International, 2013, Article ID: 354017. [Google Scholar] [CrossRef] [PubMed]
[30] 武杰, 孟昭松, 赵艳红. 颞下颌关节紊乱病在正畸治疗中的研究进展[J]. 天津医药, 2021, 49(1): 98-102.
[31] 胡敏, 贾一凡. 正畸治疗应如何规避颞下颌关节紊乱病的风险[J]. 口腔医学研究, 2021, 37(7): 583-587.
[32] Kumar, N., Daigavane, P., Jain, S. and Mantri, N. (2022) Review of Various Clinical Assessment Indices and Orthodontic Management for Temporomandibular Joint Disorders. Cureus, 14, e30492. [Google Scholar] [CrossRef] [PubMed]
[33] 贺红, 刘志坚. 正畸相关的颞下颌关节问题及临床应对策略[J]. 中华口腔医学杂志, 2019, 54(12): 808-814.

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