Kai S, Kai H, Nakayama E, Tabata O, Tashiro H, Miyajima T, Sasaguri M
First Department of Oral Surgery, Faculty of Dentistry, Kyushu University, Fukuoka, Japan.
Oral Surg Oral Med Oral Pathol. 1992 Aug;74(2):143-8. doi: 10.1016/0030-4220(92)90372-w.
Nine cases of open lock position of the condyle of the temporomandibular joint (TMJ) are reported. In two patients recurrent dislocation of the TMJ was diagnosed clinically, and four had previous episodes of anterior dislocation. An arthrotomographic examination revealed that the condyles of the affected TMJs were located anterior to the anterior bands of the disks at an open-mouth position. An arthrographic fluoroscopic examination showed that the anterior bands mechanically obstructed the anteriorly displaced condyles from posterior movement into the articular fossae to various degrees at open-mouth position. One cause of anterior dislocation of the TMJ is thought to be fixation of the condyle in the open lock position resulting from a disturbance of a neuromuscular mechanism. In the two patients with dislocation, occlusal treatment eliminated muscular symptoms and the dislocations completely disappeared.
本文报告了9例颞下颌关节(TMJ)髁突开口锁结位的病例。其中2例患者临床诊断为TMJ复发性脱位,4例有既往前脱位病史。关节体层摄影检查显示,在开口位时,患侧TMJ的髁突位于关节盘前带前方。关节造影透视检查显示,在开口位时,前带不同程度地机械性阻碍向前移位的髁突向后移动进入关节窝。TMJ前脱位的一个原因被认为是神经肌肉机制紊乱导致髁突固定在开口锁结位。在2例脱位患者中,咬合治疗消除了肌肉症状,脱位完全消失。