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[颞下颌关节损伤诊断与治疗中的当前问题]

[Current problems in the diagnosis and treatment of injuries to the temporomandibular joint].

作者信息

Sysoliatin P G, Arsenova I A

出版信息

Stomatologiia (Mosk). 1999;78(2):34-9.

Abstract

Complex examination of 2103 patients with temporomandibular joint (TMJ) injuries was carried out. This examination included contrast arthrotomography, computed tomography (CT) and MR tomography of the TMJ. It gas been established, that in mandibular condyle fractures not only bone structures of the TMJ, but also soft tissue ones (the articular disk and capsular-ligamentous apparatus) are being injured. Our investigation has shown that condylar fractures in the region of condylar base and neck are combined with the injuries of the articular disk and capsular-ligamentous apparatus in 54.1 +/- 5.4% cases, mandibular head fractures with its dislocation--in 100%. The term "TMJ injuries" reflecting the injuries of bone and soft tissue structures of the TMJ has been introduced. The classification of TMJ injuries including TMJ contusion, mandibular dislocations, condylar and glenoid fossa fractures, the injuries of the articular disk and capsular-ligamentous apparatus has been developed. Distant results of traditional methods of treatment used in TMJ trauma have been studied and the necessity of the restoring of correct relation: glenoid fossa --articular disk--mandibular head--has been shown. The method of TMJ reconstruction consisting in the restoration of TMJ bone structures and the articular disk and capsular-ligamentous apparatus has been developed.

摘要

对2103例颞下颌关节(TMJ)损伤患者进行了综合检查。该检查包括TMJ的造影关节断层摄影、计算机断层扫描(CT)和磁共振断层扫描。已经确定,在下颌髁突骨折中,不仅TMJ的骨结构,而且软组织结构(关节盘和关节囊韧带装置)也受到损伤。我们的研究表明,髁突基部和颈部区域的髁突骨折在54.1±5.4%的病例中合并有关节盘和关节囊韧带装置的损伤,下颌头骨折伴脱位的病例中这一比例为100%。引入了“TMJ损伤”这一术语,以反映TMJ骨和软组织结构的损伤。已制定了TMJ损伤的分类,包括TMJ挫伤、下颌脱位、髁突和关节窝骨折、关节盘和关节囊韧带装置损伤。对TMJ创伤中使用的传统治疗方法的远期结果进行了研究,并表明了恢复正确关系(关节窝-关节盘-下颌头)的必要性。已开发出TMJ重建方法,包括恢复TMJ的骨结构以及关节盘和关节囊韧带装置。

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