Diagnostics of mandibular articulation disorders in TMJ dysfunction patients

Diagnostics of disorders of mandibular articulation of 95 patients with TMJ dysfunction were described. Collecting the data from transcranial x-ray examination, CT, MRT and computerized axijgraphy of TMJ typical disorders of articulation of the mandibular at 4 base clinio-roentgenogical forms of TMJ dysfunction were found.     

Mandibular function and dysfunction in patients with mandibular prognathism

There are indications that in patients with mandibular prognathism there is a great risk of mandibular dysfunction symptoms. The present study was undertaken to verify this and to investigate whether surgical correction of the sagittal discrepancy would improve the functional abilities. The material comprised a group of 28 untreated patients with mandibular protrusion and another group of 44 patients who were operated on 10 years ago. The functional status and subjective symptoms were recorded according to the principles introduced by Helkimo. The results indicate a great reduction of the subjective symptoms in the treated group, and even the objective evaluation shows a reduction of the dysfunctional symptoms in the treated persons, particularly in relation to the movement capacity of the mandible. The number of occluding teeth was significantly greater in the treated persons, and the number of occlusal interferences was smaller. Thus, it seems that a repositioning of the mandible to a correct sagittal position will improve function. A normal anatomic foundation may therefore be an important factor in securing normal mandibular function.     

Maximum mandibular opening in patients with and without a history of TMJ dysfunction.

It was shown that there was no direct connection between maximum jaw opening and a history of TMJ symptoms (Fig. 7). An accurate diagnosis requires the evaluation of a wide range of signs and symptoms through both a history and a clinical examination.     

Unbalanced lateral mandibular deviation associated with TMJ sound as a sign in TMJ disc dysfunction diagnosis

The aim was to study the characteristics of lateral mandibular horizontal deviations during opening–closing movements and their association with TMJ sounds of the clicking type. Subjects were 28 healthy volunteers and 38 patients diagnosed with MRI imaging as having TMJ disc dysfunction, 22 with disc displacement without (DD) and 16 as having disc displacement with reduction (DDR). TMJ sounds were recorded with miniature microphones placed in the ear canals, and jaw movements were documented with a kinesiograph. A sign, unbalanced lateral deviation (ubd) was defined as a rapid, short duration, change in jaw movement direction from, and back to, a smooth deviation path in the horizontal plane. The hypotheses were that degrees of maximal deviations, proportions of unbalanced deviation (ubd) and such deviation associated with TMJ sounds (ubdS), differ between healthy subjects and patients with DD or DDR. Comparisons between groups were made using one‐way anova and chi‐square analysis, as appropriate. No differences were found between groups regarding degree of lateral deviation per se. The proportions of ubd and ubdS were significantly higher in patients with DDR than in healthy subjects and than in patients with DD (P < 0·001), but no such differences were found between healthy subjects and patients with DD. For prediction of DDR, the sensitivity and specificity of the sign ubdS were found to be 68·8% and 89·3%, respectively. For the sign ubd, they were 100·0% and 64·3%. This indicates that the sign ubdS has diagnostic value in screening for DDR.     

Concerns of patients seeking treatment for TMJ dysfunction

One hundred fifty-seven patients, 126 women and 24 men, 10 to 75 years of age, completed a self-administered questionnaire. The questionnaire contained questions asking about the patients' chief complaint, treatment received before coming to the clinic, the patients' view of their problem, and who informed them of the possible end result of an untreated "TMJ problem." The results revealed that pain was the most commonly reported complaint (54%), discomfort and headache came second and third (52.2% and 46.5%, respectively). A significant correlation was found between inability to chew and pain, discomfort, tightness in the masticatory muscles, and locking and clicking of the joint. Most patients had received three or more types of treatment before coming to the University of Michigan, TMJ and Oral Facial pain Clinic. A significant correlation was found between an increased number of reported symptoms and an increase in the number of treatments. The most frequently used treatment methods were pain medication, mouth guard (appliances), and occlusal adjustment. Most patients (84.1%) were referred to the TMJ and Oral Facial Pain Clinic by dentists because of clicking, locking, and limitation of movement, with or without pain.     

颌骨水平向位置异常患者中颞下颌关节结构的情况分析

目的：探讨颌骨水平向异常患者中颞下颌关节结构的变化情况。方法：随机选取近两年在我科就诊的正畸患者255例,其中男性80例,女性175例,为受试对象,年龄10-45岁,常规拍摄口内全景X线片,头颅定位正侧位片及颞下颌关节开闭口位磁共振,并对关节结构情况进行观察,其结果采用SPSS17.0进行统计学分析。结果：全部255例正畸就诊患者中,左侧偏斜患者44例,关节结构异常33例,比例为75.00%,正常不偏斜患者186例,关节结构异常122例,比例为65.59%,右侧偏斜患者25例,关节结构异常21例,比例为84.00%。结论：颞下颌关节结构异常在正畸就诊人群中的比例较高,下颌偏斜患者异常比例高于正常人群。     

颌骨矢状向异常患者中颞下颌关节结构的情况分析

目的：探讨颌骨矢状向异常患者中颞下颌关节结构的变化情况。方法：随机选取近两年在我科就诊的正畸患者255例为受试对象,其中男性80例,女性175例,年龄10-45岁,常规拍摄X线片及双侧颞下颌关节开闭口位核磁共振并对关节结构情况进行观察,并采用SPSS17．0对结果进行统计学分析。结果：255例正畸就诊患者中,骨性Ⅰ类患者89例,关节结构异常54例,异常比例60．67％,骨性Ⅱ类患者96例,关节结构异常75例,异常比例78．13％,骨性Ⅲ类患者70例,关节结构异常47例,异常比例67．14％。结论：颞下颌关节结构异常在正畸就诊人群中的比例很高,其中以骨性Ⅱ类患者患病率最高。     

青少年关节盘移位与下颌偏斜相关性研究进展

<正>偏颌畸形(facial asymmetric deformity,FA)是颌骨畸形中较常见的一种类型,主要表现为面部左右不对称,上下牙中线不一致,颏部及下颌中线偏向一侧,可伴反或锁。FA多发于下颌骨,造成下颌偏斜(mandibular deviation,MD),同时影响面部的功能与美观。Haraguchi等统计了1 800例正畸患者,其     

Electromyographic screening of myogenous and arthrogenous TMJ dysfunction patients

Sixty patients, clinically examined for TMJ dysfunction, were also electromyographically screened. The TMJ dysfunction pain in forty patients was evaluated to be mainly of a myogenous origin and in fourteen patients of a mainly arthrogenous origin. Due to lack of findings in the clinical examination six patients were not to be classified into either of the two groups. They were excluded from the EMG study. For the EMG examination the patients were asked to clench for 30 s in the intercuspal position at 50% of the maximum EMG activity of the masseter muscles. Surface electromyograms of the right and the left masseter and anterior part of the temporalis muscles were monitored. The amplitude of the EMG signal, the duration of the silent period and the changes in the frequency composition of the signal during the 30 s contraction were analysed. Statistically significant differences between the two patient groups were found in EMG amplitude and in silent period duration. However, the difference in silent period duration was due to the dependency of the silent period on the activation level of the muscle. No statistically significant difference in silent period was found when this dependency was corrected for in the data. The EMG parameters related to muscular fatigue phenomena did not show any difference between the two groups. The difference in EMG amplitude and consequently the difference in silent period duration support the clinically made distinction into mainly a myogenous or mainly an arthrogenous origin of TMJ dysfunction pain.     

下颌骨骨折对颞下颌关节的影响

下颌骨骨折在颌面骨折中所占的比例较大。下颌骨的髁突是颞下颌关节的重要组成部分，在下颌骨发生骨折时，会对颞下颌关节的骨组织及软组织造成直接及间接的损伤。本文就下颌骨骨折对颞下颌关节的影响做一综述，以期为临床选择早期、正确、并发症少的治疗方法提供一定的理论依据。     

Optical density of the mandibular head in cases of TMJ dysfunction and asymmetry of masticatory muscles activity

There was an examination of 20 patients (12 women and 8 men), aged 30 to 50, with TMJ dysfunction and with partial absence and abrasion of teeth with decrease in the height of the lower facial part and distal mandible shift, and of 12 people (7 women and 5 men), aged 20 to 40, with intact dentitions using electromyography of masticatory muscles and computer tomography, followed by evaluation of the optical density of mandibular head. Analysis of the results enabled to determine the presence of disorders of the balanced activity of masticatory muscles and enables to determine alterations in the optical density of mandibular head. It is necessary to consider the obtained data in planning the prosthetic treatment and preparation of the mouth for prosthetics of patients with TMJ pathology.     

Using the Kinesiograph to measure mandibular movements during speech: a pilot study

This study was a pilot investigation to determine a method of measuring mandibular movement during speech using the Kinesiograph. Some observations and trends were evident. 1. The Kinesiograph is an excellent instrument for measuring mandibular movement in three dimensions. 2. Production of the /s/ sound can occur anywhere within a three-dimensional range rather than at one position. 3. The distance between the upper and lower incisors during speech was much less than 1 mm and was consistent throughout the range used by each subject. 4. The functional angle of mandibular movement during speech to the maxillary occlusal plane was essentially the same as the angle of rest position to centric occlusion and appeared to be related to the cephalometric occlusal plane angle. It seems likely that rest position is the key to functional mandibular movement. 5. Three-dimensional clinical studies of mandibular movement during speech using the Kinesiograph could lead to more precise answers to questions concerning mandibular function and occlusal dysfunction.     

Analysis of mandibular motion following unilateral and bilateral alloplastic TMJ reconstruction

The purpose of this study was to analyse the masticatory patterns and range of motion (maximal incisal opening (MIO), protrusion and lateral excursion) in patients who have had unilateral and bilateral temporomandibular joint (TMJ) replacement with an alloplastic prosthesis, and compare them to each other and to normal controls. Mandibular motion was examined in 18 patients, who had undergone alloplastic TMJ reconstruction, 13 with a bilateral prosthesis and 5 with a unilateral prosthesis, and in 13 normal controls. A statistically significant difference (P < 0.01) for MIO and maximum lateral excursion was observed between the bilateral group and the control group. Maximum protrusion was only statistically significantly different (P < 0.05) between the bilateral group and the control group. For the unilateral group, a statistically significant difference (P < 0.01) was seen only with maximum contralateral excursion when compared with controls. No statistically significant difference existed in MIO and protrusion between the unilateral and bilateral groups. Even though maximum ipsilateral lateral excursion was greater for the unilateral group than either left or right maximum lateral excursion by the bilateral group, this difference was not statistically significant. This study provided an in vivo analysis of mandibular motion following alloplastic TMJ reconstruction.