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A comparative study of audiology and cone beam computed tomography in TMD patients with otological symptoms through occlusal splint therapy.

医学 矢状面 颞下颌关节 髁突 锥束ct 冠状面 口腔正畸科 夹板(药) 牙科 测听 听力学 计算机断层摄影术 听力损失 外科 解剖
作者
Ke Yin,Huiqi Pang,Ziyi Guo,Haohan Guo,Xiaojing Qi,Xiaoxia Che
出处
期刊:PubMed 卷期号:93: 210-216 被引量:2
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To investigate the changes of audiological tests and the cone beam computed tomography (CBCT) measurements of temporomandibular joint (TMJ) and middle-inner ear structure after occlusal splint therapy in temporomandibular disorders (TMD) patients with otological symptoms, and explore the etiological mechanism between TMD and otological symptoms.The 25 subjects aged 18 to 40 years who diagnosed with TMD combined the otological symptoms enrolled in the study.They all had received orthodontic treatment in the outpatient clinic of the orthodontic department in Beijing Stomatological Hospital. All the subjects underwent the audiological tests of pure tone audiometry (PTA) and CBCT before and after the occlusal splint therapy.After the stabilization occlusal splint therapy, subjects with improvement or complete remission in TMD and otological symptoms accounted for 84% and 80% in all subjects respectively. There were statistically differences in the distances between condylar center (CoC) and sella (S) in sagittal and vertical directions before and after treatment, and statistically difference between ATM and S in sagittal direction. The threshold of PTA at 8000Hz were negatively correlated with the sagittal displacement of condyle and positively correlated with the coronal displacement of condyle. The thickness of top 1/3 of anterior wall of tympanum in sagittal were positively correlated with the threshold of PTA at 4000Hz.The changes in the TMJ position through occlusal splint therapy might cause the changes in structure of middle-inner ear, which might be one of the reasons for the improvement in otological symptoms.Audiology, CBCT, Otological symptoms, TMD.Indagine riguardanti le modifiche dei test audiologici e le misurazioni della tomografia computerizzata cone beam (CBCT) della struttura dell’articolazione temporomandibolare (ATM) e della strutture dell’orecchio medio interno dopo terapia occlusiva con splint in pazienti con disturbi temporo-mandibolari (TMD) e con sintomi otologici, indagando il meccanismo etiologico tra disturbi temporo-mandibolare e sintomi otologici. Metodi: sono stati arruolati nello studio 25 soggetti di età compresa tra i 18 e i 40 anni, affetti da disturbi temporo-mandibolari associati a sintomi otologici. Tutti avevano ricevuto un trattamento ortodontico presso l’ambulatorio del dipartimento di ortodonzia del Beijing Stomatological Ospedale. Tutti i soggetti sono stati sottoposti ai test audiologici di audiometria tonale pura (PTA) e CBCT prima e dopo la terapia con splint occlusale. Risultati: dopo la terapia con splint occlusale di stabilizzazione, i soggetti con miglioramento o remissione completa dei disturbi temporo-mandibolari e dei sintomi otologici rappresentavano rispettivamente l’84% e l’80% in tutti i soggetti. C’erano differenze statisticamente nelle distanze tra il centro condilare (CoC) e la sella (S) in direzione sagittale e verticale prima e dopo il trattamento e differenze statisticamente tra ATM e S in direzione sagittale. La soglia di PTA a 8000Hz si correlava negativamente con lo spostamento sagittale del condilo e positivamente con lo spostamento coronale del condilo. Lo spessore di 1/3 superiore della parete anteriore del timpano in sagittale si correlava positivamente con la soglia di PTA a 4000Hz. Conclusione: i cambiamenti nella posizione dell’ATM a seguito di terapia con splint occlusale potrebbero causare i cambiamenti nella struttura dell’orecchio medio interno, che potrebbero essere una delle ragioni del miglioramento dei sintomi otologici.

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