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[颞下颌关节类风湿关节炎的临床研究]

[Clinical study on rheumatoid arthritis of the TMJ].

作者信息

Sostmann M, Reich R H, Grapentin D, Langer H E

机构信息

Poliklinik für Kieferorthopadie der Medizinischen Hochschule Hannover.

出版信息

Dtsch Zahnarztl Z. 1990 Jul;45(7 Spec No):S70-4.

PMID:2269160
Abstract

256 individuals with inflammatory rheumatic diseases and 117 individuals of two control groups returned their questionnaires in a survey of subjective symptoms of the masticatory system. Subjective symptoms of the temporomandibular joint (tmj) were reported by 41% of the patients with rheumatoid arthritis, 29% of the patients with psoriatic arthritis, 20% of the patients with ankylosing spondylitis and 23% of the patients with other rheumatic diseases (such as Reiter's syndrome). Statistically significant differences (p less than 0.05) regarding the occurrence of "difficulties in opening the mouth wide" and "crepitus from the tmj" were found between the various types of rheumatic arthritis. In 40 patients with rheumatic diseases and tmj-symptoms the tmj was examined clinically, by orthopantomography and lateral tomography. Radiographic abnormalities were found in 68% of the patients and classified by a new radiographic index, according to the index of Steinbrocker. There were no indications for a relationship between a loss of posterior support and extensive radiographic changes of the tmj. The most common objective symptoms were pain on chewing, crepitus in the tmj and tenderness to palpation of the masticatory muscles and neck.

摘要

在一项关于咀嚼系统主观症状的调查中,256名患有炎性风湿性疾病的患者和两个对照组的117名个体返还了他们的问卷。类风湿关节炎患者中有41%报告了颞下颌关节(TMJ)的主观症状,银屑病关节炎患者中有29%,强直性脊柱炎患者中有20%,其他风湿性疾病(如赖特综合征)患者中有23%。在各种类型的风湿性关节炎之间,发现“张口困难”和“TMJ摩擦音”的发生率存在统计学显著差异(p小于0.05)。对40名有风湿性疾病和TMJ症状的患者进行了临床检查、全景X线片检查和侧位断层扫描。68%的患者发现有影像学异常,并根据斯坦布罗克指数采用一种新的影像学指数进行分类。没有迹象表明后牙支持丧失与TMJ广泛的影像学改变之间存在关联。最常见的客观症状是咀嚼时疼痛、TMJ摩擦音以及咀嚼肌和颈部触压痛。

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