Lundh H, Westesson P L
Department of Stomatognathic Physiology, University of Lund School of Dentistry, Malmö, Sweden.
Oral Surg Oral Med Oral Pathol. 1991 Dec;72(6):637-41. doi: 10.1016/0030-4220(91)90001-s.
This study investigated the frequency and distribution of clinical signs of temporomandibular joint (TMJ) internal derangement in an adult non-TMJ patient population. Four hundred three persons who participated in an epidemiologic investigation were examined for clinical signs of TMJ internal derangement by four examiners who followed a standardized form. Clinical signs of internal derangement were found in 76 persons (19%). Twenty-nine persons (7%) had reciprocal clicking and 47 (12%) had a history of clicking replaced by limitation of mouth opening with deviation to the affected side. Reciprocal clicking was associated with TMJ pain during mouth opening and with limitation of jaw movement. A history of clicking replaced by limitation of mouth opening with deviation to the affected side was associated with pain during mouth opening, limitation of opening, and palpatory tenderness of the TMJ. The study indicates that clinical signs of TMJ internal derangement are present in nearly one fifth of non-TMJ patients. Those with clinical signs of internal derangement frequently also have subjective symptoms but they have not sought treatment for these symptoms.
本研究调查了成年非颞下颌关节（TMJ）患者群体中颞下颌关节内紊乱临床体征的出现频率及分布情况。403名参与流行病学调查的人员由四名检查者按照标准化表格检查颞下颌关节内紊乱的临床体征。76人（19%）发现有内紊乱的临床体征。29人（7%）有交互性弹响，47人（12%）有弹响史，后被张口受限并向患侧偏斜所取代。交互性弹响与张口时颞下颌关节疼痛及下颌运动受限有关。弹响史被张口受限并向患侧偏斜所取代与张口时疼痛、张口受限及颞下颌关节触压痛有关。该研究表明，近五分之一的非颞下颌关节患者存在颞下颌关节内紊乱的临床体征。有内紊乱临床体征的患者常常也有主观症状，但他们并未因这些症状寻求治疗。
