Rammelsberg P, Gernet W, Neumaier U
Poliklinik für Zahnarztliche, Prothetik, Regensburg.
Dtsch Zahnarztl Z. 1990 Jul;45(7 Spec No):S61-4.
25 patients with reciprocal clicking in one or both temporomandibular joints were examined clinically and with an electronic axiographic system (SAS-System). Studying the direction of the sudden change of the condylar path during clicking, we established a tentative differential diagnosis of "centric anterior dislocations" of the disc and "eccentric posterior dislocations". Interpreting the axiographic pathways we found an eccentric posterior dislocation of the disc in 20 TMJs. But in at least 11 cases, which could be re-evaluated by magnetic resonance tomography (CMR), the diagnosis "eccentric posterior dislocation" was false. As we found several variations of anterior dislocations with a cranial and lateral deviation of the condylar path during opening clicking, the diagnosis of "eccentric disc dislocations" established by axiography was not reliable.
对25例一侧或双侧颞下颌关节存在交互性弹响的患者进行了临床检查，并使用电子轴面描记系统（SAS系统）进行检查。通过研究弹响时髁突路径突然变化的方向，我们初步建立了盘“中心性前脱位”和“偏心性后脱位”的鉴别诊断。解读轴面描记路径时，我们发现20个颞下颌关节存在盘的偏心性后脱位。但在至少11例可通过磁共振断层扫描（CMR）重新评估的病例中，“偏心性后脱位”的诊断是错误的。由于我们发现了几种开口弹响时髁突路径向颅侧和外侧偏斜的前脱位变异情况，因此通过轴面描记法建立的“偏心性盘脱位”诊断并不可靠。
