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颞下颌关节与颈椎关节之间的运动学关系。

Kinematic Relationship Between Temporomandibular and Cervical Spine Joints.

作者信息

Kaczmarek Beata, Kaczmarek Lukasz, Mysliwiec Andrzej, Lipowicz Anna, Dowgierd Krzysztof

机构信息

HOLIMEDICA Private Physiotherapy Practice, Warsaw, Poland.

Laboratory of Physiotherapy and Physioprevention, Institute of Physiotherapy and Health Sciences, Academy of Physical Education, Katowice, Poland.

出版信息

J Oral Rehabil. 2025 Sep;52(9):1496-1504. doi: 10.1111/joor.14015. Epub 2025 May 9.

Abstract

INTRODUCTION

The temporomandibular joints (TMJs) and the cervical spine exhibit a complex functional relationship due to their anatomical and biomechanical connections. Understanding how the mobility of these structures is assessed is important for comprehending their potential interplay in musculoskeletal disorders of the head and neck.

AIM

To synthesize and compare the methodologies and findings of studies that simultaneously assessed the mobility of both the TMJs and the cervical spine.

MATERIALS AND METHODS

A comprehensive search of databases was conducted to identify relevant studies. The analysis included 15 studies that objectively analyzed movements of both the TMJs and the cervical spine. The methods used for assessing TMJ and cervical spine mobility were extracted and compared.

RESULTS

The most commonly used methods for assessing TMJ mobility were rulers or calipers for linear measurements, along with the TheraBite or Cranio-Mandibular Scale. The Zebris digital axiograph was the least frequently used. For cervical spine movements, the cervical range of motion or an inclinometer was most often used. In assessing TMJ mobility, maximal mouth opening (MMO) was consistently examined, while other movements were assessed less frequently. In assessing cervical spine mobility, flexion and extension were most often examined, followed by rotation and lateral flexion in some studies, with flexion and extension of the upper cervical spine being the least frequently assessed. Notably, no study examined TMJ mobility in different head positions relative to the body in the frontal plane (i.e., during lateral flexion of the cervical spine). None of the analyzed studies considered age and sex differences. The methodological heterogeneity of the studies made it difficult to draw unambiguous conclusions. The diversity of tools and protocols used made it difficult to compare results among studies.

CONCLUSION

Further research is needed to better understand the kinematic relationship between the TMJs and the cervical spine and to develop standardized assessment protocols. The methodological inconsistencies across existing studies highlight the need for more uniform approaches in future investigations.

摘要

引言

颞下颌关节(TMJ)与颈椎由于其解剖学和生物力学联系而呈现出复杂的功能关系。了解如何评估这些结构的活动度对于理解它们在头颈部肌肉骨骼疾病中的潜在相互作用至关重要。

目的

综合并比较同时评估颞下颌关节和颈椎活动度的研究方法及结果。

材料与方法

对数据库进行全面检索以识别相关研究。分析纳入了15项客观分析颞下颌关节和颈椎运动的研究。提取并比较了用于评估颞下颌关节和颈椎活动度的方法。

结果

评估颞下颌关节活动度最常用的方法是用直尺或卡尺进行线性测量,以及使用TheraBite或颅下颌量表。Zebris数字轴面描记仪使用频率最低。对于颈椎运动,最常使用颈椎活动范围或倾角计。在评估颞下颌关节活动度时,始终会检查最大开口度(MMO),而其他运动的评估频率较低。在评估颈椎活动度时,最常检查屈伸,一些研究中其次是旋转和侧屈,而上颈椎的屈伸评估频率最低。值得注意的是,没有研究在额状面中相对于身体的不同头部位置(即颈椎侧屈期间)检查颞下颌关节活动度。分析的研究均未考虑年龄和性别差异。研究的方法学异质性使得难以得出明确结论。所使用工具和方案的多样性使得难以在不同研究间比较结果。

结论

需要进一步研究以更好地理解颞下颌关节与颈椎之间的运动学关系,并制定标准化评估方案。现有研究中方法学的不一致凸显了未来研究中采用更统一方法的必要性。

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