Kuboki T, Takenami Y, Orsini M G, Maekawa K, Yamashita A, Azuma Y, Clark G T
Department of Fixed Prosthodontics, Okayama University Dental School, Japan.
J Orofac Pain. 1999 Winter;13(1):38-48.
Stabilization appliances and mandibular anterior repositioning appliances have been used to treat patients with internal derangement of the temporomandibular joint (TMJ) based on the assumption that these appliances work by decompressing the TMJ. The purpose of this study was to indirectly test this assumption.
Bilateral TMJ tomograms of 7 subjects with unilateral anterior disc displacement without reduction (ADDwor) were taken during comfortable closure and during maximum clenching in maximum intercuspation; tomograms were also taken with the 2 types of occlusal appliances in use. Outlines of the condyle and the temporal fossa were automatically determined by an edge-detection protocol, and the minimum joint space dimension of the joints with and without ADDwor was automatically measured for each experimental condition as the outcome variable.
Upon comfortable closure and maximum clenching, the minimum joint space dimensions of the ipsilateral and contralateral joints with the use of stabilization appliances and mandibular anterior repositioning appliances were not significantly different from those seen in maximum intercuspation.
These findings do not indicate that these appliances induce an increase in joint space during closing and clenching in joints with ADDwor.
稳定矫治器和下颌前伸矫治器已被用于治疗颞下颌关节（TMJ）内紊乱患者，其依据的假设是这些矫治器通过对TMJ减压起作用。本研究的目的是间接验证这一假设。
对7名单侧不可复性盘前移位（ADDwor）受试者在舒适咬合位和最大牙尖交错位紧咬时拍摄双侧TMJ断层片；同时也在使用两种类型的咬合矫治器时拍摄断层片。通过边缘检测程序自动确定髁突和颞窝的轮廓，并将每种实验条件下有和没有ADDwor的关节的最小关节间隙尺寸作为结果变量自动测量。
在舒适咬合位和最大紧咬时，使用稳定矫治器和下颌前伸矫治器时同侧和对侧关节的最小关节间隙尺寸与在最大牙尖交错位时所见的尺寸无显著差异。
这些结果并不表明这些矫治器在ADDwor关节的咬合和紧咬过程中会导致关节间隙增加。
