颞下颌关节紊乱病多学科联合诊治的临床研究进展

doi:10.3969/j.issn.1674-8115.2026.04.013

摘要/Abstract

摘要：

全球5%~12%的人口患有颞下颌关节紊乱病（temporomandibular disorders，TMD），该病可显著影响患者的口颌系统健康及生活质量。目前，针对该类患者的多学科管理方案尚缺乏共识，而近年来包含颞下颌关节科、正畸科和正颌外科在内的关节-颌骨-咬合联合诊治理念备受关注。功能性垫作为保守治疗的常用手段，对早中期TMD患者短期疗效显著，但长期稳定性仍待验证；颞下颌关节手术和正颌手术治疗可高效恢复中晚期TMD患者的颞下颌关节功能并纠正颌骨畸形，但正颌手术对颞下颌关节的影响需进一步研究。针对伴有（骨性）错畸形的复杂TMD患者，关节-颌骨-咬合联合诊治通过多学科协同管理可实现个性化干预：功能性垫调整盘-髁关系、正畸治疗解除咬合干扰、手术治疗恢复关节与颌骨结构及功能；同时结合患者生长发育潜力制定个性化方案，争取以“最小创伤”促进关节-颌骨-咬合三维关系的长期稳定。该综述旨在为临床中TMD患者的多学科评估及个性化管理提供参考。

关键词: 颞下颌关节紊乱病, 功能性垫, 颞下颌关节手术, 正颌手术, 正畸治疗, 多学科诊疗

Abstract:

Temporomandibular disorders (TMD) affect 5%‒12% of the global population, significantly impairing orofacial health and overall quality of life. Currently, no consensus exists regarding multidisciplinary management protocols for these patients, and the joint-jaw-occlusion multidisciplinary diagnosis and treatment model—a collaborative approach involving temporomandibular joint specialists, orthodontists, and orthognathic surgeons—has attracted increasing attention in recent years. As a commonly employed conservative treatment, functional splints demonstrate significant short-term efficacy in patients with early-to-moderate TMD, although their long-term stability remains to be verified. Temporomandibular joint surgery and orthognathic surgery can effectively restore temporomandibular joint function and correct jaw deformities in patients with moderate-to-advanced TMD, whereas the impact of orthognathic surgery on the temporomandibular joint requires further investigation. For patients with complex TMD accompanied by (skeletal) malocclusion, the joint-jaw-occlusion collaborative diagnosis and treatment model enables personalized interventions through multidisciplinary management: functional splints adjust the disc-condyle relationship, orthodontic treatment eliminates occlusal interferences, and surgical treatment restores the structure and function of the joint and jaw. Meanwhile, individualized treatment plans should be formulated based on patients' growth and developmental potential, aiming to promote the long-term stability of the three-dimensional relationship among the joint, jaw, and occlusion with minimal trauma. This review aims to provide a reference for the multidisciplinary evaluation and personalized management of patients with TMD in clinical practice.

Key words: temporomandibular disorders (TMD), functional splint, temporomandibular joint surgery, orthognathic surgery, orthodontic treatment, multidisciplinary diagnosis and treatment

中图分类号:

R782.6

刘莉, 范海霞, 耿海霞. 颞下颌关节紊乱病多学科联合诊治的临床研究进展[J]. 上海交通大学学报（医学版）, 2026, 46(4): 529-536.

Liu Li, Fan Haixia, Geng Haixia. Clinical research progress in multidisciplinary collaborative diagnosis and treatment of temporomandibular disorders[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026, 46(4): 529-536.

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