Oral and Maxillofacial Surgery, 1700 Abbey Place, Charlotte, NC 28209, USA.
Int J Oral Maxillofac Surg. 2013 Feb;42(2):223-8. doi: 10.1016/j.ijom.2012.10.023. Epub 2012 Dec 5.
Finite element analysis of dynamic temporomandibular joint (TMJ) loading reveals a predominance of localization of loading laterally towards the collateral ligament regions and disc/capsule attachments to the mandibular condyle. A previous publication (Kirk, Kirk. OMS Clin North Am 2006;18:345-68) introduced biomechanical principles for surgeons to consider in the diagnostic phase of management as well as initial surgical procedure selection. The concept of impingements and their impact with development of derangement is presented in this paper with an expanded collection of imaging characteristics. Diagnostic coronal imaging using a dual photon imaging technique is presented. This technique is superior to traditional T1 and T2 weighted imaging sequences when sagittal imaging is employed. Coronal imaging using this technique adds a new dimension to preoperative imaging. Impingement presence and the discernment of early lateral disc/capsule rupture from the condyle of the mandible is superior with the dual photon technique. Images and a classification of degrees of impingement are presented. The biomechanical importance of diagnosis of impingement is discussed.
对动态颞下颌关节（TMJ）加载的有限元分析表明，加载主要集中在侧向的侧副韧带区域和盘/囊附着于下颌髁。之前的一篇出版物（Kirk，Kirk。OMS Clin North Am 2006; 18:345-68）为外科医生在管理的诊断阶段以及初始手术程序选择中考虑了生物力学原理。本文提出了关于撞击及其对紊乱发展的影响的概念，并附有更广泛的影像学特征集。提出了使用双光子成像技术的诊断冠状成像。当采用矢状成像时，该技术优于传统的 T1 和 T2 加权成像序列。使用该技术进行冠状成像为术前成像增加了一个新的维度。与双光子技术相比，撞击的存在以及从下颌髁上早期识别外侧盘/囊破裂具有更高的辨别力。展示了图像和撞击程度的分类。讨论了诊断撞击的生物力学重要性。
