Gay T, Bertolami C N, Donoff R B, Keith D A, Kelly J P
J Oral Maxillofac Surg. 1987 May;45(5):397-407. doi: 10.1016/0278-2391(87)90007-3.
This paper describes the results of a clinical study that recorded and analyzed sounds emitted from the temporomandibular joint (TMJ) during simple function as a means for differentially diagnosing disorders of the joint. The technique is based on the principle that each different disorder of the TMJ produces a different effect on the mechanical relationship between the articulating surfaces of the joint, and that these mechanical effects can be determined by analyzing joint sounds in relation to joint movement. A total of 79 patients (101 joints) were studied; 32 (46 joints) were diagnosed as having extracapsular disorders, (primarily MPD), 27 (32 joints) were diagnosed as having a displaced disc with reduction, nine (10 joints) were diagnosed as having a displaced disc without reduction, and 11 (13 joints) were diagnosed as degenerative disease (osteoarthritis/arthrosis). In addition, 25 adults (50 joints) with normal TMJs were included as controls. The results of this study demonstrated that each specific disease of the TMJ is characterized by a unique relationship between the sounds propagated by the joint and the movement of the joint. Essentially, an extracapsular disease was characterized by acoustic quiescence during natural (as opposed to maximal) jaw movement, an internal derangement by a usually symmetrical short duration click/reciprocal click, or random click complex, depending on the subcategory of the disorder, and a degenerative disease by a long duration noise during either or both jaw opening and closing. The data further suggest that the technique serves to reflect the mechanical events (and abnormalities) that are involved in function of the diseased joint and has potential for use as a clinical diagnostic tool.
本文描述了一项临床研究的结果，该研究记录并分析了颞下颌关节（TMJ）在简单功能活动期间发出的声音，以此作为鉴别诊断关节疾病的一种手段。该技术基于这样的原理：颞下颌关节的每种不同疾病都会对关节活动表面之间的力学关系产生不同影响，并且这些力学影响可以通过分析与关节运动相关的关节声音来确定。总共对79名患者（101个关节）进行了研究；32名患者（46个关节）被诊断为患有关节外疾病（主要是咀嚼肌紊乱症），27名患者（32个关节）被诊断为可复性盘移位，9名患者（10个关节）被诊断为不可复性盘移位，11名患者（13个关节）被诊断为退行性疾病（骨关节炎/关节病）。此外，纳入了25名颞下颌关节正常的成年人（50个关节）作为对照。这项研究的结果表明，颞下颌关节的每种特定疾病都具有关节传播的声音与关节运动之间独特的关系。从本质上讲，关节外疾病的特征是在自然（而非最大程度）张口运动时声音安静，关节内紊乱通常表现为对称的短时间咔哒声/往复咔哒声，或随机咔哒声复合体，具体取决于疾病的亚类，而退行性疾病的特征是在张口或闭口或两者过程中出现长时间的噪音。数据进一步表明，该技术有助于反映患病关节功能中涉及的力学事件（和异常情况），并且有作为临床诊断工具的潜力。
