Corvo G, Tartaro G, Giudice A, Diomajuta A
Department of Head and Neck, Oral Cavity and Audio-Verbal Communication, II University of Naples, Italy.
Eur J Paediatr Dent. 2003 Jun;4(2):84-8.
The aim of this work was to gather clinical data on craniomandibular (CMD)/temporomandibular joint (TMJ) disorders in a paediatric population.
The clinical study population comprised patients with TMJ disorders who were being treated in the orthognathic ambulatory clinic of the University of Naples, where an instrumental and clinical study was performed. Data were recorded for extra and intraoral findings, Angles classification and malocclusions. Radiographic examinations were carried out. Study models were fabricated for evaluation. TMJs were assessed by palpation as well as masseter, temporal, suprahyoid, sternocleidomastoid, suboccipital, paravertebral and trapezius muscles to evaluate any possible pain. Auscultation of the TMJ was used to determine presence of articular sounds and their type (cracks, crunches, clicks) by the use of a stethoscope. Pain localisation was evaluated according to these movements taking into account site, intensity, frequency, and duration. Episodes of headache were recorded according to its intensity (mild, moderate, intense), frequency (daily, weekly, monthly), site (top of the head, occiput, temple, frontal, overorbital region, back of the head) and the duration of the episodes (in minutes, hours or whether constant).
A substantial number of the 106 patients included in the study showed a malocclusion with prevalence in Angles Class II cases. Bruxism, onychophagy, TMJ pain, headache, mouth opening partial inability, mastication difficulty and articular sound were the most representative symptoms.
The identification and recognition of factors, such as malocclusions and parafunctions, are considered fundamental to early diagnosis of TMJ problems, which is the most useful way to avoid a dysfunctional state of the stomatognathic system.
本研究旨在收集儿科人群颅颌（CMD）/颞下颌关节（TMJ）紊乱的临床数据。
临床研究人群包括在那不勒斯大学正颌门诊接受治疗的颞下颌关节紊乱患者，在此进行了仪器和临床研究。记录口外和口内检查结果、安氏分类和错牙合情况。进行了影像学检查。制作研究模型用于评估。通过触诊评估颞下颌关节以及咬肌、颞肌、舌骨上肌群、胸锁乳突肌、枕下肌、椎旁肌和斜方肌，以评估是否存在疼痛。使用听诊器对颞下颌关节进行听诊，以确定关节声音的存在及其类型（摩擦音、嘎吱声、咔嗒声）。根据这些动作评估疼痛定位，同时考虑部位、强度、频率和持续时间。根据头痛的强度（轻度、中度、重度）、频率（每日、每周、每月）、部位（头顶、枕部、颞部、额部、眶上区域、头后部）和发作持续时间（分钟、小时或是否持续）记录头痛发作情况。
纳入研究的106例患者中，相当一部分存在错牙合，以安氏II类病例最为常见。磨牙症、咬甲癖、颞下颌关节疼痛、头痛、张口受限、咀嚼困难和关节弹响是最具代表性的症状。
错牙合和副功能等因素的识别和认识被认为是颞下颌关节问题早期诊断的基础，这是避免口颌系统功能障碍状态的最有效方法。
