Linde C, Isacsson G
School of Dentistry, Karolinska Institutet, Huddinge, Sweden.
J Craniomandib Disord. 1990 Summer;4(3):197-204.
Patients with disorders of the masticatory system were clinically examined with reference to tender TMJs and sore muscles of the head and neck, jaw movement range, occlusal interferences, and aberrations of the bite. The 158 patients were divided into three groups according to diagnosis: 46 with reducing disk displacement, 57 with nonreducing disk displacement, and 55 with myogenic CMD. Unilateral symptoms were found in 83% of the two TMJ groups and 47% of the myogenic CMD group. At intraoral palpation, significantly more patients with nonreducing disk displacement displayed tender sites on the symptomatic side. Tender TMJ, crepitation, and restricted condylar translation on the symptom side were significantly more common in the group with nonreducing disk displacement. Mean maximal mouth opening was 31 mm in the nonreducing disk displacement, 42 mm in the reducing disk displacement, and 47 mm in the myogenic CMD group. Total laterotrusion was significantly less in the nonreducing disk displacement group. Myogenic CMD patients had more interferences in retruded position on the symptomatic side and more tender neck and shoulder muscles. Patients with nonreducing disk displacement displayed more signs from the masticatory system than those with myogenic CMD.
对咀嚼系统紊乱的患者进行了临床检查，检查内容包括颞下颌关节压痛、头颈部肌肉酸痛、下颌运动范围、咬合干扰和咬合异常。158例患者根据诊断分为三组：46例为可复性盘移位，57例为不可复性盘移位，55例为肌源性咀嚼肌紊乱病。在两个颞下颌关节组中，83%的患者有单侧症状，在肌源性咀嚼肌紊乱病组中，这一比例为47%。口内触诊时，不可复性盘移位组中，有明显更多的患者在症状侧出现压痛部位。不可复性盘移位组中，症状侧颞下颌关节压痛、摩擦音和髁突平移受限更为常见。不可复性盘移位组的平均最大开口度为31mm，可复性盘移位组为42mm，肌源性咀嚼肌紊乱病组为47mm。不可复性盘移位组的总侧方运动明显较少。肌源性咀嚼肌紊乱病患者在症状侧后退位时的干扰更多，颈部和肩部肌肉压痛更明显。与肌源性咀嚼肌紊乱病患者相比，不可复性盘移位患者的咀嚼系统体征更多。
