牙科实践中颞下颌关节（TMJ）或口腔颌面部（OSG）损伤的诊断与预防。

Diagnosis and prevention of temporomandibular joint (TMJ) or odontostomatognathic (OSG) injury in dental practice.

作者信息

Abdel-Fattah R A

出版信息

Todays FDA. 1990 Apr;2(4):1C, 6C-8C.

PMID:2206683

Abstract

Malpractice lawsuit cases due to temporomandibular joint/soft tissue injuries following dental therapy are increasing. Therefore, dentists and their staffs must know how to recognize, document and avoid any possible aggravation or precipitation of TMJ disorder. TMJ anatomy, biomechanics and mechanisms of TMJ injuries are presented. Etiological factors such as psychological factors, parafunctional activities, malocclusion, trauma, iatrogenic causes, systemic conditions, developmental disorders, neoplastic growth or medications are discussed. Preventive measures addressed include: history-taking, patient examination, complete records, the assessment of the patient's general condition, documentation of pre-existing findings, informing and educating the patient, performing only the necessary procedures, modifying appointments, selecting less traumatic dental techniques, avoiding sudden occlusal alterations and preparedness to handle unwanted complications.

摘要

牙科治疗后因颞下颌关节/软组织损伤引发的医疗事故诉讼案件正在增加。因此，牙医及其工作人员必须知道如何识别、记录并避免颞下颌关节紊乱的任何可能加重或引发情况。本文介绍了颞下颌关节的解剖结构、生物力学以及颞下颌关节损伤的机制。讨论了心理因素、副功能活动、错牙合、创伤、医源性原因、全身状况、发育障碍、肿瘤生长或药物等病因因素。所涉及的预防措施包括：病史采集、患者检查、完整记录、评估患者的一般状况、记录既往检查结果、告知并教育患者、仅进行必要的程序、调整预约、选择创伤较小的牙科技术、避免突然的咬合改变以及做好处理意外并发症的准备。