颞下颌关节紊乱病与错(牙合)畸形特征的关系

颞下颌关节紊乱病（temporomandibular disorders,TMD）是累及颞下颌关节区和（或）咀嚼肌及相关结构的一组疾病,临床表现为关节区和（或）咀嚼肌的疼痛、开闭口运动时关节弹响及张口受限。干扰被认为是TMD主要致病因素之一,错(牙合)畸形的许多特征也被认为与TMD相关。文章回顾以往国内外相关领域研究,对TMD与错(牙合)畸形特征的关系做一阐述。     

错畸形与颞下颌关节紊乱病

颞下颌关节紊乱病(TMD)是由多因素引起的疾病,其中因素是重要的病因。关系异常可以引起TMD的症状,而错畸形矫正以后TMD症状明显减轻。亦有认为TMD与关系错乱没有直接关系,即所说的没有影响或仅有轻微影响。本文对TMD的临床表现,病因、治疗及预后等方面进展进行综述。     

错[牙合]畸形与颞下颌关节紊乱病

颞下颌关节紊乱病（TMD）是由多因素引起的疾病,其中[牙合]因素是重要的病因。关系异常可以引起TMD的症状,而错[牙合]畸形矫正以后TMD症状明显减轻。亦有认为TMD与[牙合]关系错乱没有直接关系,即所说的没有影响或仅有轻微影响。本文对TMD的临床表现,病因、治疗及预后等方面进展进行综述。     

重度深覆与颞下颌关节紊乱病的关系

与颞下颌关节紊乱病(Temporomandibular disor-der,TMD)的发病密切相关,目前已成为口腔学者们关注的焦点之一。重度深覆是临床常见的错畸形,对于口颌系统的健康、美观及功能危害严重。许多学者[1-8]认为深覆与TMD关系最为密切,是TMD的一种易感因素。国外Williamson[4]认为颅颌功能紊乱(CMD)与深覆有明显联系,对CMD患者的咬合调查分析表明深覆的比率可达80％;Berry[5]认为深覆浅覆盖的前牙关系与弹响的存     

颞下颌关节紊乱病关节盘与髁突改变的MRI表现及相关性研究现状

正常的关节盘–髁突关系对于颞下颌关节的健康十分重要，它的改变在临床上具有重要意义。磁共振成像（MRI）被认为是颞下颌关节盘–髁突关系紊乱及软组织形态成像的金标准，被广泛地用于颞下颌关节特征的评估、协助诊断以及治疗方式的选择中。目前多数研究表明颞下颌关节紊乱病（TMD）早期阶段可能表现为关节盘的前外侧移位、双凹形态的改变。关节盘形态、位置的改变进一步导致髁突长度、高度及旋转角度等发生变化，使疾病向更严重的阶段发展。TMD患者关节盘的位置和形态改变、髁突的解剖学变化与关节盘移位具有相关性，被认为引起是TMD最常见的原因。     

错[牙合]畸形与颞下颌关节紊乱病

颞下颌关节紊乱病(Temporomandibulardisorder,TMD),是口腔临床的一种常见病。一般认为 TMD 是多因素致病的,其中(牙合)因素是较为公认的易感因素及促发因素。在这些对颞下颌关节造成影响的(牙合)因素中错(牙合)畸形占据有重要的位置。自上个世纪六十年代起,不少学者就已经开始致力于 TMD 及错(牙合)畸形之间关系的研究,其中包括临     

颞下颌关节紊乱病的治疗

关于因素是否颢下颌关节紊乱病(TMD)病因之一,以及TMD的治疗,现存在着各种争议.本文回顾了有关研究及观点.目前,无论是动物实验研究,还是临床实验研究,都不足以作出因素是TMD病因之一的结论.但是, 治疗在TMD临床治疗中占有重要地位,且发挥重要作用:调能有效地缓解慢性头痛,颈痛及肩部痛; 治疗对减轻TMD患者的肌肉疼痛也显示理想效果;调位咬合板能消除一部分关节弹响.进一步探索TMD的因素,正确掌握TMD 治疗的适应证及客观科学地评价治疗的临床效果是我们今后研究的课题.     

天然药物防龋的研究概况

80年代以来,天然药物防龋逐渐受到国内外学者的关注,基于目前所广为接受的龋病病因学说,细菌及牙菌斑被认为是主要致龋因素,其中变链菌被认为是最重要的病原菌,因此防龋中药的筛选及研究工作大多从抑制变链菌生长和菌斑形成两方面入手。     

颞下颌关节紊乱病的He治疗

关于He因素是否颞下颌关节紊乱病（TMD）病因之一，以及TMD的He治疗，现在在着各种争议。本文回顾了有关研究及观点。目前，无论是动物实验研究，还是临床实验研究，都不足以作出He因素是TMD病因之一的结论。但是，He治疗在TMD临床治疗中占有重要地位，且发挥重要作用：调He能有效地缓解慢性头痛，颈痛及肩部痛；He治疗对减轻TMD患者的肌肉疼痛也显示理想效果；调位咬合板能消除一部分关节弹响。进一步探索TMD的He因素，正确掌握TMDHe治疗的适应证及客观科学地评价He治疗的临床效果是我们今后研究的课题。     

成人正畸治疗Ⅲ.成人颞下颌关节紊乱病患者正畸治疗的原则和方法

胎畸形是颞下颌关节紊乱病(temporomandibular disorders,TMD)的致病因素之一,正畸门诊中,因矫治前或矫治后"关节不适"或被颢下颌关节科诊断为TMD而转诊的成人患者十分常见,是成人正畸治疗中不可回避且应十分注意和必须慎重处置的临床问题.TMD也是口颌系统多发病,2003年,学者们对至少17个流行病学调查结果进行总结分析,结果显示,平均有41%的人有至少1项TMD症状,平均56%的人存在至少1项TMD临床体征.     

心理因素与颞下颌关节紊乱病的研究进展

心理因素在颞下颌关节紊乱病(TMD)发生发展以及治疗中的作用,一直是研究和争议的问题之一.本文对心理因素在颞下颌关节紊乱病的发生、发展和诊断治疗作用的研究进展作一综述.     

Wilson曲线与颞下颌关节紊乱病的相关性研究进展

颞下颌关节紊乱病(TMD)的病因目前尚未完全阐明,病因主要来自牙合因素、社会心理因素、解剖因素、免疫因素以及关节负荷过重等多个方面。牙合因素作为颞下颌关节紊乱病中的影响因素,在颞下颌关节紊乱病的发生及发展过程中起到了推动性的作用。牙合曲线作为牙合因素中代表因素的一种,在TMD的发病机理中占有重要的地位。牙合、颞下颌关节与咀嚼肌共同构成口颌咀嚼系统的核心,三者相互联系,互相影响。     

Additive effects of different stressors on temporomandibular disorders

A review of dental literature has been made on the etiologies of Temporomandibular dysfunction (TM). Many authors have given different explanations for TM dysfunction and recommended different treatment modalities for it. There has been considerable diversity of opinion concerning the etiology and proper treatment in both dentistry and medicine.TM dysfunction is often multifactorial in nature and may require expertise from several different professional fields for its successful treatment. This paper presents a model which explains the additive effects of different stressors that contribute to Temporomandibular disease. As more and more stressors are added to a patient's life, the patient becomes more and more likely to develop symptoms. Successful TM treatment requires the identification and elimination of as many contributing factors as possible. This paper gives an explanation of the theory, discusses some stressors, and presents a rationale for the conservative treatment of Temporomandibular disorders. There has been much investigation into and discussion of the etiology of and appropriate treatment modalities for Temporomandibular Disorders (TMD). Many different theories of etiology have been brought forward and have much value for the practitioner and patient. There is considerable diversity of opinion as to primary causative factors and, therefore, the most appropriate treatment. It is widely accepted that Temporomandibular Disorders (TMD) are multifactorial. The significance of the phrase "multifactorial etiology" may not be fully appreciated by some. This lack of appreciation is suggested from the significant polarization in dentistry and medicine concerning the etiology and appropriate treatment of Temporomandibular Dysfunction (TMD). Following is an explanation that. might unite different groups in dentistry and medicine into a more complete understanding of Temporomandibular Disorders.(ABSTRACT TRUNCATED AT 250 WORDS)     

Temporomandibular symptoms and occlusion: a review of the literature & the concept

The role of occlusal factors in the etiology of temporomandibular disorders (TMD) is reviewed. The rediscovery of TMD by J. B. Costen in 1934 and the origin of this concept are historically linked. Difficulties in scientifically studying TMD are addressed. TMD lacks specific indicators (signs and symptoms), are episodic and respond to placebos. Clinical success with specific literature (experimental, epidemiological and clinical studies) reviewed fails to support the concept that occlusal factors play a significant role in the etiology of TMD. The remodeling capacity of the temporomandibular joint demonstrates that the joint can accommodate and adapt to various occlusal conditions.     

Temporomandibular symptoms and occlusion: a review of the literature & the concept

The role of occlusal factors in the etiology of temporomandibular disorders (TMD) is reviewed. The rediscovery of TMD by J.B. Costen in 1934 and the origin of this concept are historically linked. Difficulties in scientifically studying TMD are addressed. TMD lacks specific indicators (signs and symptoms), are episodic and respond to placebos. Clinical success with specific literature (experimental, epidemiological and clinical studies) reviewed fails to support the concept that occlusal factors play a significant role in the etiology of TMD. The remodeling capacity of the temporomandibular joint demonstrates that the joint can accommodate and adapt to various occlusal conditions.     

颞下颌关节紊乱病与相关睡眠障碍的研究进展

目前颞下颌关节紊乱病病因尚不明确，患者常伴有睡眠障碍，其中睡眠相关运动障碍、睡眠相关呼吸障碍和睡眠质量与其关系尤为密切。该文从两者的流行病学、临床表现以及治疗方法几个方面进行综述，探讨睡眠障碍与颞下颌关节紊乱病的相关性，以期为颞下颌关节紊乱病的病因分析及治疗方法提供新的思路。     

Orthodontic Treatment, Genetic Factors and Risk of Temporomandibular Disorder

Traditionally, four groups of factors have been identified in the etiology of temporomandibular disorder (TMD): anatomical variation in the masticatory system; psychosocial characteristics; pain in other body regions; and demographics. Orthodontic treatment has been variously cited both as a protective and harmful factor in TMD etiology. Recently, a search has begun for a genetic influence on TMD etiology. Genetic markers can be of additional value in identifying gene-environment interactions, that is, isolating population sub-groups, defined by genotype in which environmental influences play a relatively greater or lesser etiological role. This paper reviews concepts and study design requirements for epidemiological investigations into TMD etiology. Findings are presented from a prospective cohort study of 186 females that illustrate an example of gene-environment interaction in TMD onset. Among people with a variant of the gene encoding catechol-O-methyl-transferase, an enzyme associated with pain responsiveness, risk of developing TMD was significantly greater for subjects who reported a history of orthodontic treatment compared with subjects who did not (P=0.04). While further studies are needed to investigate TMD etiology, this genetic variant potentially could help to identify patients whose risk of developing TMD is heightened following orthodontic treatment, hence serving as a risk marker useful in planning orthodontic care.     

Correlation of Occlusal Factors and Condyle Position Asymmetry with Signs and Symptoms of Temporomandibular Disorders in Young Adults

The role of the occlusion in the etiology and prevalence of temporomandibular disorders (TMD) has not been conclusively demonstrated. Occlusal factors and condyle position asymmetry as deduced from computed tomography (CT) axial scans were correlated with signs and symptoms of TMD in 49 young adults (mean age 24 years, range 15–33 years) with complete or almost complete dentition. A statistically significant correlation was noted between these signs and symptoms and occlusal variables describing asymmetry (the amount and lateral deviation of the slide from the retruded contact position (RCP) to the intercuspal position (IP), deviation of protrusion and asymmetry in bilateral cuspid occlusion). It seems that occlusal discrepancy can be a predisposing factor to TMD, especially when it is asymmetrically expressed.     

Effect of artificial occlusal interferences depends on previous experience of temporomandibular disorders

Studies on artificial interferences in subjects with no temporomandibular (TMD) history have shown adaptation to the interference within a fairly short period of time. The role of occlusal factors in the etiology of TMD has therefore been questioned. The results might have been different, however, if subjects with a prior TMD history had been included in the study groups. To test this assumption in a randomized double-blind clinical set-up, we included healthy women without (n = 26) as well as with (n = 21) an earlier TMD history. Both groups were randomly divided into true and placebo interference groups. Artificial interferences were introduced in the true interference groups and simulated in the placebo groups. The subjects were followed for 2 weeks, after which the interferences were removed. The subjects without a TMD history showed fairly good adaptation to the interferences, but the subjects with a TMD history and true interferences showed a significant increase in clinical signs compared to the other groups. We suggest that the etiological role of occlusal interferences in TMD may not have been correctly addressed in previous studies with artificial interferences and allow no conclusions as regards TMD etiology.     

The diagnostic process for temporomandibular disorders

The diagnostic process for temporomandibular disorders (TMD) is complicated by the multifactorial etiology and multiplicity of clinical signs and symptoms characterizing such disorders. Several electronic instruments and radiological techniques have been proposed over the years in the attempt to integrate clinical evaluation of TMD patients. Nonetheless, literature data still suggest that TMD diagnosis should be based on a thorough clinical assessment and international classifying scheme, also rely on standardized clinical tests to categorize TMD patients. Imaging techniques should be used to gain a better insight within the temporomandibular joint, reserving magnetic resonance to the depiction of soft tissues and computerized tomography to bone structures. EMG-based devices failed to prove effective in improving the diagnostic process for TMD, since a lack of correlation between instrumental signs and patients' symptoms has been showed. The TMD diagnostic process also relies on a psychosocial assessment of patients, which can be useful to detect a psychosocial impairment that needs to be addressed at the therapeutical level.