Buescher Jennifer J
Clarkson Family Medicine Residency, Omaha, Nebraska 68131, USA.
Am Fam Physician. 2007 Nov 15;76(10):1477-82.
Temporomandibular joint disorders are common in adults; as many as one third of adults report having one or more symptoms, which include jaw or neck pain, headache, and clicking or grating within the joint. Most symptoms improve without treatment, but various noninvasive therapies may reduce pain for patients who have not experienced relief from self-care therapies. Physical therapy modalities (e.g., iontophoresis, phonophoresis), psychological therapies (e.g., cognitive behavior therapy), relaxation techniques, and complementary therapies (e.g., acupuncture, hypnosis) are all used for the treatment of temporomandibular joint disorders; however, no therapies have been shown to be uniformly superior for the treatment of pain or oral dysfunction. Noninvasive therapies should be attempted before pursuing invasive, permanent, or semi-permanent treatments that have the potential to cause irreparable harm. Dental occlusion therapy (e.g., oral splinting) is a common treatment for temporomandibular joint disorders, but a recent systematic review found insufficient evidence for or against its use. Some patients with intractable temporomandibular joint disorders develop chronic pain syndrome and may benefit from treatment, including antidepressants or cognitive behavior therapy.
颞下颌关节紊乱症在成年人中很常见;多达三分之一的成年人报告有 one or more 症状,包括颌部或颈部疼痛、头痛以及关节内的弹响或摩擦音。大多数症状未经治疗也会改善,但对于那些自我护理疗法未能缓解症状的患者,各种非侵入性疗法可能会减轻疼痛。物理治疗方法(如离子导入法、超声药物透入法)、心理治疗方法(如认知行为疗法)、放松技巧以及补充疗法(如针灸、催眠)都用于治疗颞下颌关节紊乱症;然而,尚无疗法被证明在治疗疼痛或口腔功能障碍方面始终具有优越性。在采用可能造成无法弥补伤害的侵入性、永久性或半永久性治疗之前,应尝试非侵入性疗法。牙合治疗(如戴口腔矫治器)是治疗颞下颌关节紊乱症的常用方法,但最近的一项系统评价发现,支持或反对使用该方法的证据不足。一些患有顽固性颞下颌关节紊乱症的患者会发展为慢性疼痛综合征,可能会从包括抗抑郁药或认知行为疗法在内的治疗中获益。
Am Fam Physician. 2007-11-15
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