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[前牙反合矫治后发生颞下颌关节紊乱病的幼儿面部形态评估]

[Evaluation on facial pattern of early childhood patients with T.M.J. dysfunction occurred after anterior crossbite correction].

作者信息

Fukazawa H, Mukaiyama T, Kurita T, Urano J, Mitani H

出版信息

Nihon Ago Kansetsu Gakkai Zasshi. 1989;1(1):66-78.

PMID:2489194
Abstract

The purpose of this study was to investigate the facial pattern of early childhood patient with temporomandibular joint (TMJ) dysfunction (clicking) occurred after anterior cross-bite correction. Chincap appliance was engaged in all cases, with or without minor intraoral mechano-therapy. Materials were consisted of lateral and postero-anterior cephalograms of 50 japanese patients (6-9 years old), all showing anterior cross-bite with normal function of TMJ at pre-treatment stage. They were consisted of two groups, one was the group of 22 patients with TMJ dysfunction occurred after cross-bite correction and the other was the control group of 28 patients with no TMJ problem. Morphological measurements were done and compared between two groups. The results were as follows: 1) There was no significant difference between the TMJ group and the control group from the lateral facial pattern. 2) The upper and middle facial skeleton were symmetry in both groups, but the maxillary alveolar legion (CMo, U 1) of TMJ group was significantly from the antero-posterior view. 3) On the lower face (mandible) of the TMJ group, it was pointed out that the position of Gonion was significantly asymmetry and L 1 point and Menton were disclosed to have severe lateral displacement. It was cleared that a high incidence of temporomandibular joint dysfunction was found in mandibular asymmetry cases. It was concluded that a careful case-management is required for mandibular asymmetry patients during chicap-orthodontic therapy.

摘要

本研究旨在调查前牙反牙合矫治后出现颞下颌关节(TMJ)功能紊乱(弹响)的幼儿患者的面部形态。所有病例均使用颏兜矫治器,部分配合少量口内机械治疗。研究材料包括50名日本患者(6 - 9岁)的侧位和后前位头颅侧位片,所有患者在治疗前均表现为前牙反牙合且TMJ功能正常。患者分为两组,一组为22例反牙合矫治后出现TMJ功能紊乱的患者,另一组为28例无TMJ问题的对照组。对两组进行形态学测量并比较。结果如下:1)TMJ组和对照组在侧面面部形态上无显著差异。2)两组的中面部和上面部骨骼均对称,但从前后位观察,TMJ组的上颌牙槽突(CMo,U1)有显著差异。3)在TMJ组的下面部(下颌骨),发现下颌角位置明显不对称,L1点和颏下点有严重的侧向移位。明确了下颌不对称病例中颞下颌关节功能紊乱的发生率较高。得出结论,在颏兜正畸治疗期间,下颌不对称患者需要仔细的病例管理。

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