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颞下颌关节无牙合位

Edentulous position of the temporomandibular joint.

作者信息

Hongchen L, Jilin Z, Ning L

机构信息

Department of Stomatology, Postgraduate Medical College, Beijing, China.

出版信息

J Prosthet Dent. 1992 Mar;67(3):401-4. doi: 10.1016/0022-3913(92)90257-b.

Abstract

Two bilateral Schuller's position radiographs were made of 10 edentulous patients with complete dentures. In one radiograph, the complete dentures were in place in centric occlusion. For the other radiograph, the complete dentures were removed and the maxillary and mandibular residual ridges approximated as closely as possible. This position is referred to as the edentulous position of the temporomandibular joint (TMJ). Findings indicate that in the edentulous position the average size of the upper and posterior TMJ spaces and the distance from the center of the condyle to the center of the glenoid fossa on the Y axis of the TMJ are smaller than measurements in the intercuspal position. The size of the anterior space and the distance between the two centers on the X axis are larger in the endentulous position. Because vertical dimension is reduced in the endentulous position, the mentum is in a superior and protrusive position. The study indicates that when the maxillary and mandibular residual ridges are approximate there is a pathologic position of the TMJ and the mandible caused by the loss of all teeth. The study shows that the condyle has the potential to move backward and upward excessively. As a result of the study, the concept of the edentulous position of TMJ is introduced. This concept is important in determining the proper position of the condyle in the glenoid fossa and the correct vertical and horizontal jaw relationship of an edentulous patient when complete dentures are made.

摘要

对10名佩戴全口义齿的无牙颌患者拍摄了两张双侧许勒位X线片。在一张X线片中,全口义齿处于正中咬合位。另一张X线片则是取下全口义齿,使上颌和下颌剩余牙槽嵴尽可能紧密贴合。这个位置被称为颞下颌关节(TMJ)的无牙颌位。研究结果表明,在无牙颌位时,TMJ上后部间隙的平均大小以及在TMJ的Y轴上髁突中心到关节窝中心的距离小于正中咬合位的测量值。无牙颌位时前部间隙的大小以及在X轴上两个中心之间的距离更大。由于在无牙颌位时垂直距离减小,颏部处于较高且前突的位置。该研究表明,当上颌和下颌剩余牙槽嵴贴合时,由于所有牙齿缺失会导致TMJ和下颌骨出现病理性位置。研究显示髁突有过度向后上方移动的可能性。作为该研究的结果,引入了TMJ无牙颌位的概念。这个概念对于确定制作全口义齿时无牙颌患者髁突在关节窝中的正确位置以及正确的垂直和水平颌关系非常重要。

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