颞下颌关节紊乱综合征的中药、针灸、按摩治疗

颞下颌关节紊乱综合征(TMJDS)是咀嚼肌平衡失调，颞下颌关节各组成结构之间运动失常而引起疼痛、张口受限、弹响的综合症状。临床多采用局部封闭、理疗等方法治疗，但疗效均不理想。本文将近年来颞下颌关节紊乱综合征的中药、针灸、按摩治疗进行综述。     

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.     

颞下颌关节紊乱病的治疗

关于 因素是否颞下颌关节紊乱病（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。     

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。     

上颌咬合板治疗颞下颌关节紊乱病

为寻找治疗颞下颌关节紊乱病的有效方法。方法 对３４例颞下颌关节紊乱病伴前牙深覆 Ｈｅ患者给予上颌Ｈｅ板治疗。结果 上颌咬合板对颞下凳关节疼痛，弹响以及张口受限等临床症状有明显缓解作用。结论上颌咬合板可作为治疗颞下颌关节乱紊乱病的方法之一。     

颞下颌关节紊乱病的治疗指征

颞下颌关节紊乱病（Temporomandibular disorders，TMD）的定义：是指累及咀嚼肌或／和颞下颌关节，具有一些共同症状（如疼痛、弹响、张口受限等）的许多临床问题的总称。根据定义，我们认为TMD并不是某一种特定疾病的诊断，而是这一群相关疾病的称呼。所以临床诊断不应使用TMD这个笼统的称呼，而是应明确哪一类或哪一种疾病，已有具体的诊断标准（另文介绍）。     

中老年颞下颌关节紊乱病关节镜手术治疗

颞下颌关节紊乱病(temporomandibular disorders,TMD)是口腔科的常见病及多发病.部分病例病程迁延,经久不愈,严重影响口颌系统的功能.近年来,颞下颌关节镜手术治疗TMD已被普遍接受,作为介于保守治疗与开放性手术治疗之间的治疗方法,创伤小,并发症少,患者易于接受,在一定程度上可作为部分开放性手术的替代治疗手段.     

单点位指尖式按摩治疗颞下颌关节紊乱病临床观察

颞下颌关节紊乱病(TMD)是口腔颌面部常见的疾病之一,好发于青壮年,尤以20～30岁女性居多,常以急性发作开口痛、咀嚼痛及张口受限就诊。临床治疗方法较多,疗效不一。笔者自2004年以来,尝试采用单点位指尖式按摩治疗本病,取得了满意疗效。现总结报告如下。1材料与方法1.1一般资料     

正畸治疗与颞下颌关节紊乱病关系的研究进展

颞下颌关节紊乱病是口腔临床常见病之一.一般认为颢下颌关节紊乱病是由多因素导致的咀嚼肌功能紊乱、颞下颌关节异常和退行性改变.近几十年来,正畸治疗与颢下颌关节紊乱病之间可能存在的关系一直是正畸医生研究和关注的焦点.本文就两者之间关系的研究作一.     

The longevity of temporomandibular disorder improvements after active treatment modalities

Of concern to practitioners and patients alike are the long-term results following temporomandibular disorder/craniofacial pain (TMD/CP) treatments. This paper examines 270 patients who underwent active TMD/CP treatment and had follow-up an average of 41 months after the termination of treatment when the patients had reached maximum medical improvement (MMI). Data show that, notwithstanding a mild degree of recrudescence, overall levels remain significantly lower than initial baseline symptoms, indicating a long-term benefit from active treatment. It could not be determined whether the recrudescent symptom levels were related to the conditions for which patients initially sought treatment or to new pathological states. Possible considerations for relapse may be the function of aging, musculoskeletal structural adaptation, resorting to parafunctional habits, and/or a change in psychosocial status. No significant differences were found between males and females regarding symptom levels and outcomes. Clinical experience suggests that TMD/CP symptoms do not resolve spontaneously and generally require active treatment. Unfortunately, most studies to date have largely measured symptom changes immediately (or very shortly) after the completion of treatment. This article, however, finds that the benefits of appropriate active TMD treatments remain long after treatment completion.     

A型肉毒毒素治疗颞下颌关节紊乱病的临床研究

目的 评价A型肉毒毒素局部注射治疗颞下颌关节紊乱病（TMD）的临床疗效。方法 对11例经保守治疗无效的TMD患者,给予局部注射A型肉毒毒素150U,双侧嚼肌各50U,双侧颞肌各25U。分析治疗前后不同时期患 者的最大张口度、疼痛值、口颌功能及局部压值的变化。结果 治疗徨不同时期患者最大张口度、疼痛、口颌功能及局部压均较治疗前有显著改善（P＜0.05）。结论 A型肉毒毒素局部注射治疗TMD,能有效改善患者的张口度,缓解疼痛。     

The effect of orthognathic surgery on temporomandibular disorder

This study aimed to evaluate the difference in prevalence of temporomandibular disorder (TMD) before and after orthognathic surgery (OGS), particularly in patients with mandibular asymmetry.A prospective cohort study of patients undergoing corrective orthognathic surgery was conducted. Pre-operative and post-operative (3 months, 6 months and 1 year) TMD assessment were performed according to the Diagnostic Criteria for TMD (DC/TMD) protocol.64 patients were included in the study. Overall, there was a significant reduction of 26.5% in TMD prevalence from 60.9% pre-operatively to 34.4% 1-year post-operatively (p = 0.003). In all, 37.5% of patients had their TMD condition treated, 50% had no change in their symptoms while 12.5% experienced a worsening of their symptoms. No significant difference in terms of change in TMJ status was observed among the different ramus procedures, the type and magnitude of mandibular movement, skeletal class, and presence of mandibular asymmetry.In conclusion, it appears that corrective orthognathic surgery for dentofacial deformities might provide a secondary benefit of treating TMD. However, surgeons have to be aware that a small percentage of patients might experience a deterioration of their TMD condition, and that those who were previously asymptomatic may develop TMD symptoms after surgery.     

Efficacy of low-level laser therapy in the treatment of temporomandibular disorder

AIMS: To evaluate the effectiveness of low-level laser therapy (LLLT) in patients presenting with temporomandibular disorder (TMD) in a random and placebo-controlled research design. METHODS: The sample consisted of 40 patients, divided into an experimental group (G1) and a placebo group (G2). The treatment was done with an infrared laser (830nm, 500mW, 20s, 4J/point) at the painful points, once a week for four consecutive weeks. The patients were evaluated before and after the treatment through a Visual Analogue Scale (VAS) and the Craniomandibular Index (CMI). RESULTS: The baseline and posttherapy values of VAS and CMI were compared by the paired T-test, separately for the placebo and laser groups. A significant difference was observed between initial and final values (p < 0.05) in both groups. Baseline and post-therapy values of pain and CMI were compared in the therapy groups by the two-sample T-test, yet no significant differences were observed regarding VAS and CMI (p > 0.05). CONCLUSION: After either placebo or laser therapy, pain and temporomandibular symptoms were significantly lower, although there was no significant difference between groups. The low-level laser therapy was not effective in the treatment of TMD, when compared to the placebo.     

Myogenous temporomandibular disorder patients and the temporomandibular opening index

Limited mandibular movement is one of the cardinal signs of temporomandibular disorders, and is usually assessed by measurement of mouth opening. Linear measurement of mouth opening does not discriminate between diagnostic groups and has been shown to be influenced by gender, age and ramus length. A new temporomandibular opening index, however, can differentiate between diagnostic groups and is not influenced by the above variables. When patients with a myogenous temporomandibular disorder were examined, the temporomandibular opening index distinguished two subgroups, the first with values about the lower quartile and the second with values about the upper quartile. A similar identification of two subgroups was seen in electromyographic studies of myogenous temporomandibular disorder patients.     

咬合紊乱对颞下颌关节盘厚度的影响

目的 :探讨咬合紊乱对颞下颌关节盘厚度的影响。方法 :12具尸体的 2 3侧颞下颌关节 ,5具尸体有以下咬合紊乱特征之一设为咬合紊乱组 :后牙缺失久未修复造成的邻牙倾斜、对颌牙伸长 ;第三磨牙因无对牙合牙而伸长 ;个别后牙的反牙合或锁牙合。 7具尸体没有上述表现者设为对照组。TMJ石蜡切片 ,HE染色观察。动物实验 :18只新西兰大白兔 ,9只以固定矫治技术将第一前磨牙拉向其近中的自然间隙 ,形成渐进性咬合紊乱 ,另 9只作对照 ,3个月后TMJ切片观察。结果 :尸体解剖及动物实验均表明 ,咬合紊乱组关节盘明显厚于对照组 (P <0 .0 5 )。结论 :关节盘可随咬合紊乱而作厚度方面的改建。