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跨学科方法治疗颞下颌关节骨关节炎——文献综述。

Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis-Review of the Literature.

机构信息

Department of Orthodontics, Medical University of Lodz, 90-419 Lodz, Poland.

Department of Prophylaxis and Experimental Dentistry, Jagiellonian University in Krakow, 31-007 Krakow, Poland.

出版信息

Medicina (Kaunas). 2020 May 9;56(5):225. doi: 10.3390/medicina56050225.

Abstract

There are an increasing number of patients applying for dental treatment who suffer from temporomandibular joint osteoarthritis (TMJOA). Osteoarthritis may be the cause of the pain in the area of temporomandibular joints, but its course may also be absolutely asymptomatic. The aim of this study was to present an interdisciplinary approach to TMJOA, including current diagnostics and treatment modalities on the basis of the available literature. PubMed and Scopus databases were analyzed using the keywords: ((temporomandibular joint AND osteoarthritis) AND imaging) and ((temporomandibular joint AND osteoarthritis) AND treatment). The bibliography was supplemented with books related to the temporomandibular joint. After screening 2450 results, the work was based in total on 98 publications. Osteoarthritis is an inflammatory, age-related, chronic and progressive degenerative joint disease. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT), together with clinical symptoms, play significant roles in TMJOA diagnosis. Current MRI techniques seem to be clinically useful for assessment of bony changes in temporomandibular joint (TMJ) disorders. Treatment of TMJOA requires a complex, interdisciplinary approach. TMJOA treatment includes the cooperation of physiotherapists, rheumatologists, gnathologists, orthodontists and quite often also maxillofacial surgeons and prosthodontists. Sometimes additional pharmacotherapy is indicated. Thorough examination of TMJ function and morphology is necessary at the beginning of any orthodontic or dental treatment. Undiagnosed TMJ dysfunction may cause further problems with the entire masticatory system, including joints, muscles and teeth.

摘要

越来越多患有颞下颌关节骨关节炎(TMJOA)的患者申请牙科治疗。骨关节炎可能是颞下颌关节区域疼痛的原因,但也可能完全无症状。本研究旨在介绍 TMJOA 的跨学科方法,包括基于现有文献的当前诊断和治疗方式。使用关键词在 PubMed 和 Scopus 数据库中进行分析:((temporomandibular joint AND osteoarthritis) AND imaging) 和 ((temporomandibular joint AND osteoarthritis) AND treatment)。参考文献还补充了与颞下颌关节相关的书籍。在筛选了 2450 个结果后,这项工作总共基于 98 篇出版物。骨关节炎是一种炎症性、与年龄相关、慢性和进行性退行性关节疾病。磁共振成像(MRI)和锥形束计算机断层扫描(CBCT)与临床症状一起,在 TMJOA 诊断中发挥重要作用。目前的 MRI 技术似乎在评估颞下颌关节(TMJ)疾病的骨变化方面具有临床应用价值。TMJOA 的治疗需要复杂的、跨学科的方法。TMJOA 的治疗包括物理治疗师、风湿病学家、颌学专家、正畸医生的合作,并且经常还需要颌面外科医生和修复科医生的合作。有时还需要进行额外的药物治疗。在任何正畸或牙科治疗开始之前,都需要对 TMJ 的功能和形态进行彻底检查。未诊断的 TMJ 功能障碍可能会导致整个咀嚼系统(包括关节、肌肉和牙齿)出现进一步的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fe9/7279162/e056e800c671/medicina-56-00225-g001.jpg

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