肌位牙合板对颅颌功能紊乱者髁突位置及盘突关系异常影响的研究

目的　研究颅颌功能紊乱（ Ｃ Ｍ Ｄ） 者牙尖交错位（ Ｉ Ｃ Ｐ） 的髁位及戴入肌位牙合板后的改变， 对戴入肌位牙合板后颞颌关节（ Ｔ Ｍ Ｊ） 弹响消失者， 观察盘突关系的变化。方法　对１０２ 例 Ｃ Ｍ Ｄ 者在 Ｉ Ｃ Ｐ 及戴入肌位牙合板后咬合接触时， 在断层深度不变的情况， 分别进行双侧 Ｔ Ｍ Ｊ侧位中层摄影， 对其中９ 例戴板后弹响立即消失者行戴板前、即刻戴入牙合板后及治疗后， Ｔ Ｍ Ｊ上腔造影的断层摄影。结果　１０２ 例 Ｃ Ｍ Ｄ 者 Ｉ Ｃ Ｐ 时， 髁突一侧后位或双侧后位４３ 例， 中位４６ 例， 一中一前６ 例， 双侧前位７ 例。戴入牙合板后， 后位者３０ 例双侧居中， 中位者３６ 例前下移，而髁位异常在戴板后持不变者５ 例。９ 例盘突关系异常者， 戴入牙合板后全部恢复正常， 但３ ～６ 月后去板， 仅１ 例盘突关系正常，８ 例仍异常。结论　肌位牙合板可使后位的髁突居中， 居中者前下调位并纠正不对称的髁位， 而对盘突关系异常的调整作用有限。

The effect of muscular position splint on condylar position and abnormal disk condyle relationship in patients with craniomandibular disorders

Objective To compare the condylar position in intercupal position with that when biting on muscular position splint for Craniomandibular Disorder (CMD) patients and observe the changes of disk condyle relationship in those CMD patients with the temporomandibular joint (TMJ) clicking disappeared after the insertion of muscular position splint. Methods TMJs Tomography was carried out in 102 patients with and without the splint in situ at the same layer. Arthrography and then Tomography was finished in 9 patients with the TMJ clicking disappeared when the splint was in situ.Results In 102 patients, there showed bilateral or unilateral posterior condylar position in 43 cases, central position in 46 cases, central psoition on one side and anterior position on the other in 6 cases and bilateral anterior position in 7 cases. After the splint was inserted, the posterior one turned to central position bilaterally in 30/43 of the cases, while the central one moved downward and forward in 36/46 of the cases. The abnormal disk condyle relationship turned to normal in all patients examined with splint in situ. But, the disk condyle relationship still showed abnormal in 8 of the 9 patients when the splint was weaned off after 3 to 6 monthes. Conclusion The effect of muscular position splint on condylar position was to adjust the abhormal position with the result of the posterior one turned to certral position, the central one turned to downward and forward, and correct the asymmetry position in the fossa. The splint has little effect on abnormal disk condyle relationship.