Sawai K, Ishibashi K, Asada K, Hamada K, Fukaya T, Naohara H, Yamanaka K, Jibiki M, Kobayashi K
Nihon Ago Kansetsu Gakkai Zasshi. 1989;1(1):195-208.
To investigate the movement of the articular disk in recurrent luxations, 4 temporomandibular joints in three patients were studied with the arthrotomographs. All the superior articular cavities were extended anteriorly. On the mouth open in two patients with recurrent subluxation, the mandibular head accompanied with the articular disk located very anterior position from the articular tubercle. At this time, the retro-discal pad were stretched, but the relation between mandibular head and articular disk were normal findings: the mandibular head located on the central thin part of the articular disk. One of them showed anterior disk displacement with reduction. The other patient showed the bone cavity at the anterior slope of the articular tubercle. On the mouth open, the mandibular head and posterior band fitted that cavity. The other hand, remaining one patient was recurrent luxation on the left side. On the mouth open, the relation between mandibular head and articular disk were abnormal findings: The mandibular head located very anterior position, over the articular tubercle and anterior band of the disk. Therefore, the inferior articular cavity was extended, but the retro-discal pad was not stretched. The anterior slope of the articular tubercle was steep. The other side TMJ of this patient was recurrent subluxation and anterior disk displacement with reduction. On the mouth open, it was showed the hypermobility of mandibular head. But the relation between mandibular head and articular disk were normal findings. As mentioned above, in luxation and subluxation, it was made obvious that there were tow types about the relation between mandibular head and articular disk on the mouth open: one type was that mandibular head located anteriorly to the anterior band of the disk, the other was under the disk.
为研究复发性脱位时关节盘的运动，用关节断层摄影术对3例患者的4个颞下颌关节进行了研究。所有上关节腔均向前扩展。在2例复发性半脱位患者张口时，下颌头与关节盘位于关节结节前方很远的位置。此时，盘后垫被拉伸，但下颌头与关节盘的关系为正常表现：下颌头位于关节盘的中央薄部。其中1例显示关节盘可复性前移位。另1例患者在关节结节前斜面有骨腔。张口时，下颌头和后带与该腔相适配。另一方面，其余1例患者为左侧复发性脱位。张口时，下颌头与关节盘的关系为异常表现：下颌头位于非常靠前的位置，超过关节结节和关节盘的前带。因此，下关节腔扩展，但盘后垫未被拉伸。关节结节的前斜面陡峭。该患者的另一侧颞下颌关节为复发性半脱位和可复性关节盘前移位。张口时，显示下颌头活动过度。但下颌头与关节盘的关系为正常表现。如上所述，在脱位和半脱位时，张口时下颌头与关节盘的关系明显存在两种类型：一种类型是下颌头位于关节盘前带的前方，另一种是位于关节盘下方。
