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TMJ 运动中后髁突位置时关节间隙减小。

Reduced joint distance during TMJ movement in the posterior condylar position.

机构信息

Department of Oral and Maxillofacial Surgery, BK21 2nd Program for Craniomaxillofacial Life Science, Dental Research Institute, School of Dentistry, Seoul National University, Republic of Korea.

出版信息

J Craniomaxillofac Surg. 2013 Oct;41(7):e159-64. doi: 10.1016/j.jcms.2012.12.005. Epub 2013 Mar 5.

Abstract

Biomechanical loading reduces joint distance and has a causative relationship with disc displacement in temporomandibular joint and/or osteoarthritis. Condylar movement and pathways during mouth opening and closing are different depending on the condylar position in the glenoid fossa. Therefore, physical loading on the articular disc or condylar head would also be different in different condylar positions. The aim of this study was to evaluate the 3-dimensional changes of joint distance in different anterior-posterior condylar positions. We divided 52 temporomandibular joints into anterior, concentric, and posterior condylar positions using transcranial radiographs. We traced the condylar movements by simulating mandibular movement with 3-dimensional computed tomography data and a position-tracking camera. The joint distance during temporomandibular joint movement was significantly narrower, and the length of condylar pathways with narrower joint distance was longer in the posterior condylar position than in the concentric (p < 0.05) or anterior condylar positions (p < 0.01). Our study suggests that the posterior condylar position experiences more physical loading than other positions. Therefore, the position may have an accelerating or worsening effect on biomechanical loading-related temporomandibular joint disorder in cases of harmful parafunctional activities such as excessive mouth opening, clenching, and bruxism.

摘要

生物力学负荷会减小关节间隙,与颞下颌关节和/或骨关节炎中的髁突移位具有因果关系。开口和闭口过程中髁突的运动轨迹和路径因髁突在关节窝中的位置而异。因此,在不同的髁突位置,关节盘或髁突头的物理负荷也会不同。本研究旨在评估不同前后向髁突位置的关节间隙三维变化。我们使用经颅放射摄影将 52 个颞下颌关节分为前位、同心位和后位。我们通过使用三维计算机断层扫描数据和位置跟踪相机模拟下颌运动来追踪髁突运动。与同心位(p<0.05)或前位(p<0.01)相比,后位时关节间隙明显变窄,且伴有更窄关节间隙的髁突运动路径更长。我们的研究表明,后位时关节承受的物理负荷比其他位置更大。因此,在后位时,在诸如过度张口、紧咬牙和磨牙等有害的功能紊乱性活动中,该位置可能对与生物力学负荷相关的颞下颌关节紊乱具有加速或恶化作用。

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