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急性和慢性不可复性盘前移位临床对比研究
引用本文:傅开元,张寒冰,赵燕平,马绪臣,张震康.急性和慢性不可复性盘前移位临床对比研究[J].中华口腔医学杂志,2004,39(6):471-474.
作者姓名:傅开元  张寒冰  赵燕平  马绪臣  张震康
作者单位:100081,北京大学口腔医学院颞下颌关节病口颌面疼痛诊治中心
基金项目:首都医学发展基金资助项目 (2 0 0 3 3 0 0 7)
摘    要:目的 探讨颞下颌关节紊乱病不可复性盘前移位急性和慢性分类对临床诊断、治疗和预后的指导意义。方法 分析连续接诊的 10 0例不可复性盘前移位病例 (急性 4 5例、慢性 5 5例 ) ,比较两组之间临床主诉、开口度、颞下颌关节功能、髁突和关节盘的影像学改变。结果 急性不可复性盘前移位主诉开口受限 ,下颌运动功能严重障碍 ,大部分病例髁突骨质正常 ,关节盘形态良好 ;慢性不可复性盘前移位主诉多为开口痛和 (或 )咀嚼痛 ,下颌运动受限 ,部分病例伴有咀嚼肌疼痛 ,相当一部分病例髁突骨质吸收破坏 ,关节盘变形、变性 ,关节盘附着松弛、撕裂 ,甚至关节盘穿孔。结论 对急性不可复性盘前移位应早期采取积极的治疗 ,恢复良好的盘 突关系 ,阻止关节盘和髁突的进一步损伤。

关 键 词:颞下颌关节  颞下颌关节盘  颞下颌关节紊乱病
修稿时间:2004年6月7日

Comparative study on the clinical appearances between acute and chronic anterior disc displacement without reduction
FU Kai-yuan,ZHANG Han-bing,ZHAO Yan-ping,MA Xu-chen,ZHANG Zhen-kang. Center for Temporomandibular Disorders and Orofacial Pain,Peking University School of Stomatology,Beijing ,China.Comparative study on the clinical appearances between acute and chronic anterior disc displacement without reduction[J].Chinese Journal of Stomatology,2004,39(6):471-474.
Authors:FU Kai-yuan  ZHANG Han-bing  ZHAO Yan-ping  MA Xu-chen  ZHANG Zhen-kang Center for Temporomandibular Disorders and Orofacial Pain  Peking University School of Stomatology  Beijing  China
Institution:Center for Temporomandibular Disorders and Orofacial Pain, Peking University School of Stomatology, Beijing 100081, China. kqkyfu@bjmu.edu.cn
Abstract:OBJECTIVE: To compare the clinical appearances of TMD patients between acute and chronic anterior disc displacement without reduction. METHODS: Successive one hundred TMD patients with fully recorded documents diagnosed as anterior disc displacement without reduction (ADDw/oR) were included, 45 acute and 55 chronic ADDw/oR patients. Clinical appearances including signs and symptoms, maximal mouth opening, Fricton's craniomandibular index, condylar bone changes on radiograms, findings on arthrograms and MRI were compared. RESULTS: The main reason for asking treatment was joint pain in chronic, instead of limited mouth opening in acute patients. Clinical symptoms such as pain and limited mandibular movement showed improvement in chronic patients. Fricton's joint dysfunction index was higher in acute than in chronic patients, but muscle palpation index was higher in chronic than in acute patients, but Fricton's craniomandibular index was not significantly different between chronic and acute patients. The destructive bone changes of condyle on radiograms, the damage of stretched disc attachment on arthrograms and the morphological deformed disc on MRI were more frequently found in chronic than in acute patients. CONCLUSIONS: In acute patients there is a great likelihood that tissues are healthy and not morphologically changed, we suggest that early and efficacious intervention should be made to reposition the anterior displaced disc that may block the progress of pathological impairment to both the disc and the condyle of TMJ.
Keywords:Temporomandibular joint  Temporomandibular disk  Temporomandibular disorders
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