Shaffer Stephen M, Brismée Jean-Michel, Sizer Phillip S, Courtney Carol A
Department of Rehabilitation Sciences, School of Allied Health Sciences, Texas Tech University Health Sciences Center, USA.
Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, USA.
J Man Manip Ther. 2014 Feb;22(1):2-12. doi: 10.1179/2042618613Y.0000000060.
Temporomandibular disorders (TMD) are a heterogeneous group of diagnoses affecting the temporomandibular joint (TMJ) and surrounding tissues. A variety of methods for evaluating and managing TMD have been proposed within the physical therapy profession but these sources are not peer-reviewed and lack updates from scientific literature. The dental profession has provided peer-reviewed sources that lack thoroughness with respect to the neuromusculoskeletal techniques utilized by physical therapists. The subsequent void creates the need for a thorough, research informed, and peer-reviewed source regarding TMD evaluation and management for physical therapists. This paper is the first part in a two-part series that seeks to fill the current void by providing a brief but comprehensive outline for clinicians seeking to provide services for patients with TMD. Part one focuses on anatomy and pathology, arthro- and osteokinematics, epidemiology, history taking, and physical examination as they relate to TMD. An appreciation of the anatomical and mechanical features associated with the TMJ can serve as a foundation for understanding a patient's clinical presentation. Performance of a thorough patient history and clinical examination can guide the clinician toward an improved diagnostic process.
颞下颌关节紊乱病（TMD）是一组影响颞下颌关节（TMJ）及其周围组织的异质性诊断。物理治疗专业领域已经提出了多种评估和管理TMD的方法，但这些资料未经同行评审，也缺乏科学文献的更新。牙科专业提供了经过同行评审的资料，但在物理治疗师所使用的神经肌肉骨骼技术方面不够全面。因此，需要有一份针对物理治疗师的关于TMD评估和管理的全面、基于研究且经过同行评审的资料。本文是一个两部分系列的第一部分，旨在通过为寻求为TMD患者提供服务的临床医生提供一个简要但全面的概述来填补当前的空白。第一部分重点介绍与TMD相关的解剖学和病理学、关节运动学和骨运动学、流行病学、病史采集以及体格检查。了解与TMJ相关的解剖学和力学特征可为理解患者的临床表现奠定基础。全面的患者病史采集和临床检查可以指导临床医生改进诊断过程。
