Sato Shuichi, Nasu Fumiko, Motegi Katsutoshi
Department of Oral and Maxillofacial Surgery I, Tohoku University School of Dentistry, Sendai, Japan.
J Oral Maxillofac Surg. 2002 Aug;60(8):867-72. doi: 10.1053/joms.2002.33854.
The purpose of this study was to examine changes of chewing movement and masticatory efficiency during the natural course of nonreducing disc displacement of the temporomandibular joint (TMJ).
The subjects were 15 patients who had been diagnosed with nonreducing disc displacement of the TMJ but had received no treatment. Chewing movement and masticatory efficiency were examined at the initial visit and at a mean follow-up of 21.7 months, using mandibular kinesiography and adenosine triphosphate ebteric-coated granules. As a control, 23 persons who had no current or previous TMJ symptoms were studied.
The patients' clinical signs and symptoms tended to be alleviated during the follow-up period. In normal controls, chewing movement showed lateral excursion to the chewing side on both the right and left sides. In patients, chewing movement at the initial visit showed lateral excursion to the chewing side during chewing on the TMJ affected side, but no such deviation was noted during chewing on the TMJ unaffected side in the horizontal plane. However, chewing movement at follow-up became similar to that of controls. In patients, masticatory efficiency became better during the natural course, although that at follow-up did not always reach the control's level.
In untreated patients with nonreducing disc displacement of the TMJ, chewing movement and masticatory efficiency tend to improve spontaneously.
本研究旨在探讨颞下颌关节(TMJ)不可复性盘移位自然病程中咀嚼运动和咀嚼效率的变化。
研究对象为15例诊断为TMJ不可复性盘移位但未接受治疗的患者。在初诊时及平均随访21.7个月时,使用下颌运动描记法和三磷酸腺苷肠溶片对咀嚼运动和咀嚼效率进行检测。作为对照,研究了23例目前或既往无TMJ症状的人。
随访期间患者的临床体征和症状趋于缓解。在正常对照组中,咀嚼运动在左右两侧均向咀嚼侧侧方偏移。在患者中,初诊时咀嚼运动在患侧TMJ咀嚼时向咀嚼侧侧方偏移,但在水平面非患侧TMJ咀嚼时未观察到此类偏移。然而,随访时的咀嚼运动变得与对照组相似。在患者中,自然病程中咀嚼效率有所提高,尽管随访时并不总是达到对照组水平。
在未经治疗的TMJ不可复性盘移位患者中,咀嚼运动和咀嚼效率往往会自发改善。