正畸治疗在颞下颌关节病治疗中的作用

1　材料与方法1.1　病例来源　治疗组及封闭组的所有病例均来自我科正畸及口腔外科组 1999年 2月至 2 0 0 0年 1月确诊的ＴＭＪＤ门诊病员 ,正畸组来自我科同期就诊的常规正畸病员。普查组来自同期我科对中学生的普查资料。所有观察对象均年龄控制在 11～ 12岁 ,由同一组正畸及口腔外科专科医师记录病史、临床检查、石膏模型和Ｘ线投影测量结果。并排除下列情况 :①器质性ＴＭＪＤ ,②牙列缺失者 ,③严重的牙周疾病 ,④既往经过正畸或ＴＭＪＤ治疗者 ,⑤全身系统性疾病 ,⑥随诊不足 2年者。1.2　研究方法　①治疗组 :符合病例入选条件 ,行单…     

自由基与退行性颞下颌关节病

退行性颞下关节病的分子机制尚不明确。最新的研究表明关节中的损伤性自由基的积聚,并由此引起的一系列组织损害的分子过程是引起退行性颞下关节病的主要机制,本文对颞下颌关节中自由基的结构特性,产生途径及作用过程作一综述。     

咬合板治疗颞下颌关节病的护理配合

颞下颌关节病是口腔的常见病、多发病之一 ,是由于各种原因引起颞下颌关节间隙改变 ,关节腔压力增大 ,使关节盘受挤压前移、变形甚至穿孔 ,因而运动时使双板区受压而产生疼痛、弹响和运动异常等症状。临床治疗首选保守治疗 ,其中以咬合板治疗为主[1] 。咬合板治疗的原理是增加垂直距离 ,使关节间隙改变 ,降低关节内的压力 ,使咀嚼肌松弛 ,因而使关节疼痛缓解或消失、弹响减弱 ,运动异常也可得到不同程度的改善[2 ,3 ] 。治疗方法分三步 :第一步 ,取模 ,制取人造石模型。第二步 ,制作咬合板。根据病人口腔具体情况在上颌或下颌模型上铺蜡 ,平…     

正颌正畸治疗与颞下颌关节病发生的研究进展

正颌手术结合正畸技术可以治疗牙颌面骨性畸形。其治疗有助于患者功能，外貌，社交的改善。正颌正畸治疗对颞下颌关节的影响是学者们长期关注的方面，因此本文就正颌正畸治疗与颞下颌关节病的发生，转变关系做一综述。     

颞下颌关节病多媒体教学系统研制与应用

采用多媒体技术ＰＣ机上研制的颞下颌关节病多媒体教学系统具有图、文、声、像并茂的特点，充分利用计算机辅助教学在交互式教学方面的优越性，强主财以学生为中心，整个学习过程生动有趣，使学生具有强烈的自我教学参与感 。     

活性维生素D与颞下颌关节病的研究进展

颞下颌关节是双侧联动关节,是人体内最复杂、最精密的骨关节之一。目前国内外学者认为有很多因素会导致颞下颌骨关节病的发生,如遗传、精神因素、老龄化、骨密度降低、关节损伤、某些营养因素缺乏等。活性维生素D[1,25?（OH）2D3]是细胞外钙磷平衡的重要调节者,同时对骨骼肌系统也有广泛的生物学作用。活性维生素D缺乏对颞下颌关节病影响重大,主要表现在对关节髁突结构、软骨细胞、软骨下骨及关节内炎症因子等方面,本文主要就活性维生素D对颞下颌关节病的发生、发展的研究进展进行综述。     

下颌外伤后对颞下颌关节的影响

下颌外伤后对颞下颌关节的影响是多方面的,本文通过对国内外相关资料的综述,提示下颌外伤后髁状突的移位、关节窝的骨折、颌间固定时间的长短对颞下颌关节有重要影响,应当引起临床工作者的高度重视.     

压力痛阈测试在颞下颌关节病中的应用

压力痛阈测试(pressure pain threshold,PPT)作为定量感觉测试的一项指标已经被用于颞下颌关节病的临床研究,其在揭示疾病疼痛的发生机制、预测疾病发展过程、判断不同治疗的临床效果差异等方面有巨大作用。本文就PPT在颞下颌关节病中的研究进展及其局限性作一综述。     

颞下颌关节紊乱病关节盘前后界限改变的核磁共振定位研究

目的:通过对关节盘前后界限的测定,确定颞下颌关节紊乱病患者关节盘移位改变的情况,探讨其临床意义.材料与方法:16例经临床确诊为颞下颌关节紊乱病患者行颞下颌关节(TMJ)的核磁共振(MRI)检查与13例正常人的MRI影像进行对比分析.结果:T1图像矢状位时,在TMD组,关节盘前缘位于关节结节最低点垂直线前约0.43mm,而正常组则位于其前约0.13mm,两组间差异无统计学意义,闭口位时在TMD组关节盘后缘与双板区交界处约位于关节四中心垂直线81°处,而正常组则位于其93.31°处,两组间有统计学差异.结论:TMD组在闭口位时,关节盘均可有明显的前移,但前缘前移变化不大,这与关节盘形态改变状况一样均为颞下颌关节紊乱病的重要指征.     

单侧有症状的颞下颌关节紊乱病患者双侧关节间隙锥形束CT对比研究

目的探讨单侧有症状的颞下颌关节紊乱病患者双侧颞下颌关节在CBCT成像上可能存在差异的参考层面,为颞下颌关节紊乱病诊断和对比研究提供参考。方法选取一侧TMJ有症状的TMD患者87例,通过CBCT三维成像和重建,观察同一患者两侧TMJ重建后横断面的水平角;平行于髁突长轴的斜位关节间隙、髁突长轴径值、髁突垂直角;垂直于髁突长轴的斜位与矢状位的关节结节斜度和关节间隙,采用SPSS13.0软件包对每位患者上述各测量指标做两配对样本t检验。结果两侧TMJ在平行位120°、矢状位60°和90°、垂直位60°和120°时的关节间隙测量值差异均有统计学意义(P<0.05),其中矢状位90°关节间隙的差异更显著(P<0.01),其余值均无统计学差异。结论对于单侧有症状的TMD患者,矢状位或垂直位是较易观察到左右两侧有差异的位置,在垂直位和矢状位均观察到前间隙的增大,在这个层面重建对诊断和对比研究更有意义。     

Impact of prolotherapy in temporomandibular joint disorder: a quality of life assessment

Chronic pain and functional impairment associated with temporomandibular joint (TMJ) disorders (TMD) considerably reduce oral health-related quality of life (OHRQoL). In the present study we have assessed the influence of prolotherapy in patients with TMD by the subjective measurement of QoL using the Oral Health Impact Profile-14 (OHIP-14). Twenty-five patients diagnosed with TMD (mean (range) age 38 (18 – 70) years) were included. They had all undergone dextrose prolotherapy to the TMJ at regular time intervals (four times at intervals of two weeks) using the method suggested by Hemwall-Hackett. They were asked to answer the OHIP-14 questionnaire before and two years after prolotherapy. Seven domains of OHRQoL were rated on a 5-point Likert scale from 0 (never) to 4 (very often). Domain scores and total OHIP-14 scores were compared using inferential statistics (chi squared and Wilcoxon signed rank tests). Prolotherapy was effective over time, as all the domains’ mean scores decreased considerably after treatment. The total mean score before prolotherapy was 21.20, which was extensively reduced to 13.08 after prolotherapy (p=0.001). There was statistically significant improvement in all domains, including functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap (p≤0.005 in all cases). We concluded that prolotherapy has a promising role in the improvement of OHRQoL of patients with TMD, and its beneficial effects persist at least two years after treatment.     

Frequency of temporomandibular disorder signs and symptoms among call center employees

Objective: The current study aimed to investigate the frequency of signs and symptoms of temporomandibular disorders (TMD) among call center employees.

Methods: Workers from four call centers (CC) were invited to participate in this study. The examination was based on the Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD). The tenderness of the masticator muscles was assessed on both sides by bilateral palpation. The mobility of the mandible was measured with a plastic millimeter ruler on opening, lateral excursions, and protrusion.

Results: In total, 124 call center employees with a mean age of 28.61 ± 4.71 (between 22 and 47 years of age) were enrolled in this study. There was no statistically significant relation between the numbers of calls answered in a day and teeth clenching, teeth grinding, earache, tinnitus, or pain on yawning/chewing. Only protrusive movement pain and joint noise were significantly higher among employees who answered more than 140 calls/day (p < 0.01). An evaluation of the TMD signs and symptoms in relation to job stress level revealed that job stress level significantly affected the incidence of headaches among call center employees (p < 0.01).

Conclusion: The present study demonstrated no statistically significant relation between TMD signs and symptoms and call center employees except protrusive movement pain and joint noise. This relation was seen only in the employees who answered more than 140 calls per day. Headache, teeth clenching, and TMJ noise were the signs and symptoms encountered most often in this study. Multicentered studies in different geographic locations should be conducted to eliminate the limitation of this study.     

Prevalence of temporomandibular joint disorder among North Saudi University students

The aim of the current investigation was to study the prevalence of temporomandibular disorder (TMD) among university students of North Saudi Arabia.

Methods:A specifically constructed questionnaire was distributed to 489 university students to investigate the prevalence of temporomandibular joint (TMJ) findings among them. The study sample consisted of 346 males and 143 females (age range was 18–25?years). The data were analyzed, and probability values were set at p?≤?0.05.

Results:A total of 49.7% of participants had at least one sign or symptom of TMD. Clicking was the most reported finding. Pain in or about the ears/cheeks was the second most common finding. In all, 24.3% of the participants reported one TMJ finding; meanwhile, 0.4% reported the presence of five concurrent TMJ signs and symptoms. Females reported more TMJ signs and symptoms than males (p?p?Discussion:University students in north Saudi Arabia reported high prevalence of TMD. Also, students from science and health colleges reported higher prevalence of TMD findings than humanitarian college students. Clicking and pain are the most prevalent findings of TMD among university students. The results of this investigation highlight the need for additional research to shed more light on the risk factors and findings related to TMD. This will facilitate drawing adequate guidelines for prevention and management of TMD.     

颞下颌关节区疼痛患者全身伴随症状的初步研究

目的调查与颞下颌关节(TMJ)区疼痛伴随出现的全身症状的发生情况。方法选取TMJ区疼痛患者51例及TMJ区无疼痛的对照者31人,调查其TMJ症状及全身伴随症状。治疗半年后对TMJ区疼痛患者进行复查。应用一元线性回归和卡方检验对TMJ区疼痛与全身症状的相关性及伴随性进行统计学分析。结果与TMJ疼痛有相关性的症状包括头痛、背痛、手麻抖、肩颈痛、失眠、目眩、听力下降、眼痛和易疲劳(P<0.05)。患者组部分症状(头痛、肩颈痛、眼痛、耳鸣、目眩、眼下抽搐、易疲劳、手脚发凉、易烦躁、注意力不集中和消化不良)发生的比例显著高于对照组(P<0.01)。半年后与TMJ区疼痛伴随改善的症状有头痛、肩颈痛和易疲劳(P<0.05)。结论头部、肩颈等口腔颌面邻近器官的症状是TMJ区疼痛的主要伴随症状,与TMJ症状的改善有伴随关系。     

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目的评价伴有颞下颌关节紊乱病（TMD）症状的错铪患者使用拾板治疗的效果。方：去对2011年4-11月福建医科大学附属口腔医院正畸科就诊的41例伴有TMD症状的错矜畸形患者使用耠板治疗,应用颅颌指数（CMI）定量分析治疗前后的颞下颌关节（TMJ）状态。结果41例患者经3个月铪板治疗后的功能障碍指数（DI）和CMI均较治疗前明显下降,差异有统计学意义（P〈0．001）;而触诊指数（PI）在治疗前后的差异无统计学意义（P〉0．05）。结论袷板治疗可明显改善错袷畸形患者TMJ功能状态。     

Malignancy of the parotid gland with primary symptoms of a temporomandibular disorder

The purpose of this case report is to highlight the possibility that malignant neoplasms of the deep lobe of the parotid gland may present as a temporomandibular disorder (TMD). Two patients who were eventually diagnosed with deep-lobe parotid tumors were retrospectively analyzed clinically, radiographically, and pathologically. For the first patient, there was a prolonged delay in establishing the correct diagnosis; for the second patient the delay was shorter. This was done primarily by computed tomographic examination. Despite aggressive surgical, radiotherapeutic, and chemotherapeutic treatment, both patients died from their malignant disease. All clinicians who treat TMD must be aware of the rare possibility of deep-lobe parotid tumors presenting as a TMD.     

Efficiency of arthrocentesis treatment for different temporomandibular joint disorders

This study was performed to determine whether arthrocentesis therapy has different outcomes in three groups of patients with different temporomandibular disorders (TMDs). A clinical trial was conducted including 45 patients with 45 unilaterally affected joints divided into three groups (n = 15): osteoarthritis (OA), disc displacement with reduction (DDWR), and disc displacement without reduction (DDWoR). All patients underwent the same arthrocentesis treatment protocol. The outcome variables, including visual analogue scale evaluations and measurements of mandibular motion (in millimetres), were recorded at baseline and at 1 and 6 months postoperative. Inter-group assessments showed significant short-term differences in joint sounds (P = 0.016) and significant long-term differences in masticatory efficiency (P = 0.046) and protrusive movement (P = 0.048). The estimation of mean changes between baseline and long-term follow-up revealed significant differences in joint sounds (P < 0.001), disruption in daily activities (P = 0.002), maximum mouth opening (P = 0.008), and protrusive movement (P = 0.002) between the groups. Arthrocentesis therapy may be useful to improve clinical symptoms and range of mandibular movement in patients with all three types of TMD. However, the benefit of arthrocentesis may be greater for patients with DDWoR than for those in the other groups.