Liu Mu-Qing, Lei Jie, Han Jian-Hui, Yap Adrian U-Jin, Fu Kai-Yuan
Peking University School & Hospital of Stomatology, Center for TMD & Orofacial Pain and Department of Oral & Maxillofacial Radiology, Beijing, China.
National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.
J Appl Oral Sci. 2017 Sep-Oct;25(5):483-489. doi: 10.1590/1678-7757-2016-0471.
To evaluate the effect of bite positions characterizing different splint treatments (anterior repositioning and stabilization splints) on the disc-condyle relation in patients with TMJ disc displacement with reduction (DDwR), using magnetic resonance imaging (MRI).
37 patients, with a mean age of 18.8±4.3 years (7 male and 30 females) and diagnosed with DDwR based on the RDC/TMD, were recruited. MRI metrical analysis of the spatial changes of the disc/condyle, as well as their relationships, was done in three positions: maximum intercuspation (Position 1), anterior repositioning splint position (Position 2), and stabilization splint position (Position 3). Disc/condyle coordinate measurements and disc condyle angles were determined and compared.
In Position 1, the average disc-condyle angle was 53.4° in the 60 joints with DDwR, while it was -13.3° with Position 2 and 30.1° with Position 3. The frequency of successful "disc recapture" with Position 2 was significantly higher (58/60, 96.7%) than Position 3 (20/60, 33.3%). In Positions 2 and 3, the condyle moved forward and downward while the disc moved backward. The movements were, however, more remarkable with Position 2.
Anterior repositioning of the mandible improves the spatial relationship between the disc and condyle in patients with DDwR. In addition to anterior and inferior movement of the condyle, transitory posterior movement of the disc also occurred.
使用磁共振成像（MRI）评估表征不同夹板治疗（前伸复位夹板和稳定夹板）的咬合位置对颞下颌关节可复性盘前移位（DDwR）患者盘-髁关系的影响。
招募了37例患者，平均年龄18.8±4.3岁（7例男性和30例女性），根据RDC/TMD诊断为DDwR。在三个位置对盘/髁的空间变化及其关系进行MRI测量分析：最大牙尖交错位（位置1）、前伸复位夹板位（位置2）和稳定夹板位（位置3）。确定并比较盘/髁坐标测量值和盘髁角度。
在位置1，60个DDwR关节的平均盘髁角度为53.4°，而在位置2为-13.3°，在位置3为30.1°。位置2成功“盘复得”的频率（58/60，96.7%）显著高于位置3（20/60，33.3%）。在位置2和3，髁突向前下方移动，而盘向后移动。然而，位置2的移动更显著。
下颌前伸复位可改善DDwR患者盘与髁突之间的空间关系。除了髁突向前下方移动外，盘还出现短暂的向后移动。
