Porto Vinícius Carvalho, Salvador Mílton Carlos Gonçalves, Conti Paulo César Rodrigues, Rotta Rejane Ribeiro
Department of Prosthodontics, Bauru School of Dentistry, University of São Paolo, Brazil.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Jan;97(1):116-21. doi: 10.1016/j.tripleo.2003.07.003.
This study evaluated the condyle-disc relationship on magnetic resonance image (MRI) in a group of subjects with silent temporomandibular joints (TMJs) when tested clinically with those in subjects with discernible temporomandibular sounds. Study design Twenty-five completely edentulous patients were selected to participate in this study. The study was based on bilateral MRIs of 15 patients (with articular sound) and 10 symptom-free volunteers (control).
It was noted that disc displacement was found in 45% of the TMJs with no history of articular sounds. In 6 TMJs of control group, a reducing disc displacement was found, and in 3 TMJs a permanent displacement was found. Disc displacements were identified in 70% of patients. Reducing disc displacement was found in 19 of these TMJs, whereas permanent displacement was found in 2 TMJs. In 9 of the joints of the symptomatic group, a superior disc position was found. Also verified was a significant association between reducing disc displacement and biconvex disc.
These observations demonstrated that internal derangements can not be associated to clicking joints or symptoms of temporomandibular disorders in elderly edentulous patients, and the presence of displaced discs seems to be associated to altered disc morphology, but not to osseous abnormalities.
本研究通过磁共振成像（MRI）评估了一组临床检查时颞下颌关节（TMJ）无杂音的受试者与有可察觉颞下颌关节声音的受试者之间的髁突-盘关系。研究设计：选取25名全口无牙患者参与本研究。该研究基于15名患者（有关节弹响）和10名无症状志愿者（对照组）的双侧MRI。
值得注意的是，在无关节声音病史的TMJ中，45%发现有盘移位。在对照组的6个TMJ中，发现有可复性盘移位，3个TMJ发现有不可复性盘移位。在70%的患者中发现了盘移位。在这些TMJ中的19个发现有可复性盘移位，而在2个TMJ中发现有不可复性盘移位。在有症状组的9个关节中，发现盘位置上移。还证实了可复性盘移位与双凸盘之间存在显著关联。
这些观察结果表明，在老年无牙患者中，关节内紊乱与关节弹响或颞下颌关节紊乱症状无关，盘移位的存在似乎与盘形态改变有关，而与骨质异常无关。
