Litko M, Berger M, Szkutnik J, Różyło-Kalinowska I
Department of Functional Masticatory Disorders, Medical University of Lublin, Lublin, Poland.
Independent Unit of Propedeutics of Dental and Maxillofacial Radiology, Medical University of Lublin, Lublin, Poland.
J Oral Rehabil. 2017 Dec;44(12):957-963. doi: 10.1111/joor.12576. Epub 2017 Oct 6.
The most common temporomandibular joint (TMJ) internal derangement is an abnormal relationship of the disc with respect to the mandibular condyle, articular eminence and glenoid fossa-disc displacement. The aim of our study was to analyse the correlation between partial/complete disc displacement in the intercuspal position (IP) and its reduction in the open-mouth position (OMP) in both oblique sagittal and coronal planes on magnetic resonance imaging (MRI) in patients with temporomandibular disorders. Multisection MRI analysis of 382 TMJs was conducted in 191 patients with disc displacement according to the RDC/TMD criteria (148 women, 43 men; aged 14-60 years). The disc position was evaluated on all oblique sagittal and coronal images in the IP and the OMP. Univariate logistic regression analysis showed that the severity of disc displacement in the sagittal plane is a statistically significant predictor of reduction ability during mouth opening (B = 3.118; P < .001). Moreover, the severity of disc displacement in both planes is also a significant predictor of disc reduction in OMP (B = 2.200; P < .05). In conclusion, reduction ability during mouth opening is associated with the severity of disc displacement in IP, in both sagittal and coronal planes. Multisection analysis of all MR images allows distinguishing the correct disc position from disc displacement and can improve the ability to distinguish between various stages of TMJ internal derangement.
最常见的颞下颌关节(TMJ)内部紊乱是关节盘相对于下颌髁突、关节结节和关节窝的异常关系——关节盘移位。我们研究的目的是分析颞下颌关节紊乱患者在磁共振成像(MRI)的斜矢状面和冠状面上,牙尖交错位(IP)时关节盘部分/完全移位与其在开口位(OMP)时复位情况之间的相关性。根据RDC/TMD标准,对191例有关节盘移位的患者的382个颞下颌关节进行了多层面MRI分析(148名女性,43名男性;年龄14 - 60岁)。在IP位和OMP位的所有斜矢状面和冠状面图像上评估关节盘位置。单因素逻辑回归分析表明,矢状面关节盘移位的严重程度是张口时复位能力的统计学显著预测指标(B = 3.118;P <.001)。此外,两个平面上关节盘移位的严重程度也是OMP位关节盘复位的显著预测指标(B = 2.200;P <.05)。总之,张口时的复位能力与IP位矢状面和冠状面关节盘移位的严重程度相关。对所有MR图像进行多层面分析能够将正确的关节盘位置与关节盘移位区分开来,并可提高区分TMJ内部紊乱各个阶段的能力。