J David Allen Professor and Division Chief, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA.
Associate Professor, Department Of Oral and Maxillofacial Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
J Oral Maxillofac Surg. 2024 Jun;82(6):623-631. doi: 10.1016/j.joms.2024.01.003. Epub 2024 Jan 6.
The understanding of the causes of temporomandibular joint pain and dysfunction has evolved over 50 years. Historically, the term internal derangement has been used to describe the abnormal relationship between the articular disc, condyle, and glenoid fossa, which was thought to correlate with patient symptoms. It is now known that the pathophysiology of intra-articular pain and dysfunction (IPD) involves synovitis, capsular impingement, symptomatic disc displacement, or a combination of these. Symptomatic disc displacement should only be considered to be a potential source of IPD after synovitis and capsular impingement have been treated. This philosophy provides the opportunity for most patients with IPD to be initially treated nonsurgically or with minimally invasive procedures such as arthrocentesis or arthroscopy.
颞下颌关节疼痛和功能障碍的病因理解已经发展了 50 多年。从历史上看，术语“内部紊乱”一直被用来描述关节盘、髁突和关节窝之间的异常关系，这被认为与患者的症状相关。现在已知，关节内疼痛和功能障碍（IPD）的病理生理学涉及滑膜炎、囊夹、有症状的盘移位，或这些的组合。只有在滑膜炎和囊夹撞击得到治疗后，才能考虑有症状的盘移位是 IPD 的潜在来源。这种理念为大多数 IPD 患者提供了机会，使他们可以首先接受非手术治疗或微创治疗，如关节穿刺术或关节镜检查。
