Kecik Defne, Kocadereli Iliken, Saatci Isil
Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
Angle Orthod. 2005 Jan;75(1):54-62. doi: 10.1043/0003-3219(2005)075<0054:CDRAVE>2.0.CO;2.
A proper diagnosis is the key to successful treatment. The purpose of this study was to evaluate the temporomandibular joints (TMJ) by means of lateral and anteroposterior cephalograms, transcranial temporomandibular radiographs, magnetic resonance imaging (MRI), and TMJ electrovibratography (EVG) in asymptomatic and orthodontically untreated Angle Class I subjects. The study sample comprised 31 (13 boys, 18 girls) asymptomatic Class I children with a mean age of 9.7 years. The lateral cephalometric findings revealed that the subjects were mesofacial with an Angle Class I skeletal relationship, and the anteroposterior cephalograms showed a symmetrical craniofacial skeleton. Transcranial TMJ radiographs showed that the TMJs on both sides were symmetrically positioned. The time-frequency distributions of sounds from both right and left TMJs showed a wide range, and the vibrations measured by EVG were considerable. The MRI revealed unilateral disc displacement with reduction in four of the 31 subjects (13%), bilateral disc displacement with reduction in three subjects (10%), and bilateral disc displacement without reduction in one subject (3%). The data confirm that a standardized clinical examination to determine the status of the joint is not an efficient tool. This study suggests that the clinical diagnosis should be supported by extensive TMJ evaluation techniques.
正确的诊断是成功治疗的关键。本研究的目的是通过侧位和前后位头影测量片、经颅颞下颌关节X线片、磁共振成像(MRI)以及颞下颌关节电振动图(EVG),对无症状且未经正畸治疗的安氏I类受试者的颞下颌关节(TMJ)进行评估。研究样本包括31名(13名男孩,18名女孩)无症状的I类儿童,平均年龄为9.7岁。侧位头影测量结果显示,受试者为中等面型,具有安氏I类骨骼关系,前后位头影测量片显示颅面部骨骼对称。经颅颞下颌关节X线片显示双侧颞下颌关节位置对称。左右颞下颌关节声音的时频分布范围较广,通过EVG测量的振动幅度较大。MRI显示,31名受试者中有4名(13%)出现单侧可复性盘移位,3名受试者(10%)出现双侧可复性盘移位,1名受试者(3%)出现双侧不可复性盘移位。数据证实,用于确定关节状况的标准化临床检查并非有效工具。本研究表明,临床诊断应得到广泛的颞下颌关节评估技术的支持。