口腔颌面外科杂志2026，Vol.36Issue(2)：121-127,7.DOI:10.12439/kqhm.1005-4979.2026.02.006
伸长第三磨牙拔牙前后对颞下颌关节影响的临床研究
Clinical study on the effects of elongated third molar extraction on the temporomandibular joint
摘要
Abstract
Objective:To investigate the effects of elongated third molars on the temporomandibular joint function,masticatory muscle electromyographic activity,and joint space.Methods:A total of 24 patients with elongated third molars who attended the outpatient clinic of the Department of Oral and Maxillofacial Surgery at the First Affiliated Hospital of Xinjiang Medical University from April 2024 to February 2025 were selected.Among them,14 had unilateral elongation and 10 had bilateral elongation.The following parameters were compared before and 3 months after the extraction of the elongated third molars:Maximum mouth opening,range of mandibular border movements(protrusion,lateral movement,retrusion),tenderness threshold of the temporomandibular joint area,mean amplitude of surface electromyography(sEMG)of the bilateral anterior temporalis(TA)and masseter muscles(MM),asymmetry index(AsI)of the masticatory muscles,and bilateral temporomandibular joint space(anterior,superior,and posterior joint spaces).Results:Three months after tooth extraction,the patients'maximum mouth opening increased.In the maxillary elongation group,the range of mandibular protrusion and retrusion increased,while in the mandibular elongation group,the range of mandibular protrusion increased.The tenderness threshold of the bilateral TMJ area in both the unilateral and bilateral elongation groups was higher than that before extraction(all P<0.05).In patients with unilateral elongated third molars,the mean sEMG amplitudes of the TA on the elongated side were significantly higher than that on the non-elongated side before extraction.After extraction,there was no statistically significant difference in the mean sEMG amplitude of the TA and MM between the two sides(P>0.05).Compared with before extraction,the mean sEMG amplitudes of the TA and MM on both the elongated and non-elongated sides increased after extraction in patients with unilateral elongation,and the AsI of the bilateral TA decreased.In patients with bilateral elongation,there were no statistically significant differences in the mean sEMG amplitudes and AsI of the bilateral TA and MM before and after extraction(P>0.05).In patients with unilateral elongation,the anterior joint space of the bilateral TMJ decreased and the posterior joint space increased after extraction compared with that before extraction(all P<0.05).In patients with bilateral elongation,there were no statistically significant differences in the anterior and superior joint spaces before and after extraction(P>0.05).Conclusion:Unilateral elongation of the third molar can lead to asymmetry in the electromyographic activity of the masticatory muscles,an increase in the anterior joint space,and a decrease in the posterior joint space of the TMJ.Extraction of the elongated third molar can effectively improve these abnormalities.关键词
伸长第三磨牙/颞下颌关节/咀嚼肌表面肌电/锥形束CT/关节间隙Key words
elongated third molar/temporomandibular joint/surface electromyography of the masticatory muscles/cone beam CT/joint space分类
医药卫生引用本文复制引用
高扎尔·布哈热阿力,姜昊彧,宋志强,Habeeb Hussam,张璐,龚忠诚..伸长第三磨牙拔牙前后对颞下颌关节影响的临床研究[J].口腔颌面外科杂志,2026,36(2):121-127,7.基金项目
国家自然科学基金(82160189) （82160189）
