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颞下颌关节在自由闭口和负重闭口运动过程中的关节内距离。

The intra-articular distance within the TMJ during free and loaded closing movements.

作者信息

Huddleston Slater J J, Visscher C M, Lobbezoo F, Naeije M

机构信息

Department of Oral Function, Academic Center for Dentistry Amsterdam, ACTA, The Netherlands.

出版信息

J Dent Res. 1999 Dec;78(12):1815-20. doi: 10.1177/00220345990780120801.

Abstract

Previous studies on free opening and closing movements of the mandible have demonstrated that the opening movement traces of the condylar kinematic center (i.e., the condylar point for which the protrusive and the opening movement traces coincide) lie closer to the articular eminence than the closing traces. This indicates the presence of an intra-articular distance within the joint during free closing. Since the mandible behaves like a class III biomechanical lever, a counteracting mechanical load on the mandible during closing will press the condyle-disc complex against the articular eminence. Therefore, in this study the hypothesis was tested that the difference between opening and closing movement traces of the kinematic center is reduced when the closing movements are counteracted by a mechanical load. From 10 healthy participants, 20-second movement recordings were obtained by a six-degrees-of-freedom opto-electronic jaw movement recording system (OKAS-3D) for three types of movements: (1) free opening and closing movements, (2) free opening and loaded closing movements (i.e., the participants closed against a small or high manually applied downward-directed force to the chin), and (3) gum chewing. Off-line, the opening and closing movement traces of the kinematic center were reconstructed, and the average difference between the traces (the intra-articular distance) was calculated. The average intraarticular distance was significantly smaller during loaded closing than during free closing, whereas no significant differences were found in the intra-articular distances between the loaded situations of low and high manual loading and contralateral chewing (ANOVA and post hoc Bonferroni multiple comparisons of means test, p<0.005). In conclusion, loading of the mandible during closing movements reduces the intra-articular distance within the temporomandibular joint.

摘要

以往关于下颌骨自由开闭运动的研究表明,髁突运动中心(即前伸和开口运动轨迹重合的髁突点)的开口运动轨迹比闭口轨迹更靠近关节结节。这表明在自由闭口过程中关节内存在关节间隙。由于下颌骨的行为类似于Ⅲ类生物力学杠杆,闭口过程中作用于下颌骨的反作用机械负荷会将髁突 - 盘复合体压向关节结节。因此,在本研究中,我们检验了这样一个假设:当闭口运动受到机械负荷的反作用时,运动中心的开口和闭口运动轨迹之间的差异会减小。从10名健康参与者中,通过六自由度光电颌运动记录系统(OKAS - 3D)获取了三种运动的20秒运动记录:(1)自由开口和闭口运动,(2)自由开口和负重闭口运动(即参与者对着下巴手动施加小或大的向下力进行闭口),以及(3)咀嚼口香糖。离线状态下,重建了运动中心的开口和闭口运动轨迹,并计算了轨迹之间的平均差异(关节间隙)。负重闭口时的平均关节间隙明显小于自由闭口时,而在低手动负荷和高手动负荷的负重情况以及对侧咀嚼之间的关节间隙未发现显著差异(方差分析和事后Bonferroni多重比较均值检验,p < 0.005)。总之,闭口运动过程中对下颌骨施加负荷会减小颞下颌关节内的关节间隙。

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