Rybalov Oleg V., Yatsenko Pavel I., Yatsenko Oleg I, Khorosh Maksim V., Korol Dmitry M., Kindiy Dmitry D., Kindiy Victor D.
Ukrainian Medical Stomatological Academy, Poltava, Ukraine
Kyiv International University, Kyiv, Ukraine
Wiad Lek. 2019 Oct 31;72(10):1883-1889.
Among the large contingent of patients with TMJ dysfunctions, there are persons with hypermobility of the joint heads of the lower jaw. Moreover, at present, the question of the frequency of occurrence of hypermobility of articular heads of the TMJ is not reflected. The aim of the work is to find out the frequency of occurrence of hypermobility of articular head among a healthy population and to evaluate the clinical, radiological, and electromyographic characteristics of the muscular-articular complex in these individuals.
Surveys were conducted for 476 students aged 19 to 25 years. For people with revealed articular hypermobility of the articular heads, chewing and temporal muscle electromyography, TMJ aiming zonography in a lateral projection with open and closed mouth were performed with an assessment of the correspondence of the articular fossa of the temporal bone to the size of the articular head, the location of the articular heads relative to the apex of the articular tubercle.
Of the examined 476 students, 95 people (20%) revealed hypermobility of the articular heads of TMJ. According to the results of clinical, functional and radiological studies of TMJ, we identified three degrees of hypermobility: light, moderately expressed, significant. With light to moderate degree of hypermobility, electromyography of the temporal and chewing muscles and TMJ zonography did not reveal a difference in performance compared to healthy ones. Most of the examined did not note functional discomfort from the joints. With a significant degree of hypermobility of the articular heads, electromyography of the temporal and chewing muscles revealed a lack of synergism in their work. On TMJ zonograms with an open mouth, the articular heads extended anteriorly beyond the tops of the articular tubercles almost under their outer base.
It has been established that hypermobility of the joint heads of the TMJ, which does not cause signs of pathology in the form of masticatory function disorders, discoordination of the masticatory muscles and uncontrolled displacements of the lower jaw, the presence of a pain symptom should be considered as a variant of norm.
在大量颞下颌关节功能障碍患者中，存在下颌关节头活动过度的人群。此外，目前颞下颌关节关节头活动过度的发生率问题尚无相关报道。本研究的目的是了解健康人群中关节头活动过度的发生率，并评估这些个体肌肉 - 关节复合体的临床、放射学和肌电图特征。
对476名年龄在19至25岁的学生进行了调查。对于关节头出现活动过度的人群，进行了咀嚼肌和颞肌肌电图检查，以及颞下颌关节在开口和闭口时的侧位投照定位造影，评估颞骨关节窝与关节头大小的对应关系、关节头相对于关节结节顶点的位置。
在检查的476名学生中，95人（20%）出现了颞下颌关节关节头活动过度。根据颞下颌关节的临床、功能和放射学研究结果，我们确定了三种活动过度程度：轻度、中度、重度。在轻度至中度活动过度时，颞肌和咀嚼肌的肌电图以及颞下颌关节造影显示，与健康人群相比，其表现没有差异。大多数受检者未注意到关节的功能不适。在关节头重度活动过度时，颞肌和咀嚼肌的肌电图显示它们在工作中缺乏协同作用。在开口时的颞下颌关节造影图上，关节头向前延伸至几乎超出关节结节顶部的外侧基部下方。
已证实，颞下颌关节关节头活动过度，若未引起咀嚼功能障碍、咀嚼肌失调和下颌不受控制的移位等病理症状，且无疼痛症状，应被视为一种正常变异。
