Moss M L
Dent Clin North Am. 1983 Jul;27(3):445-55.
It is inappropriate for the nonclinician to qualitatively assess the several currently available therapies for treating TMJ dysfunction. However, it is pertinent to note that the matters reviewed in this article may assist the clinician by providing some deeper insights into the biomechanical bases of any successful therapy. TMJ dysfunction is a summary term for a broad spectrum of joint malfunctions, variously termed. These may be related to congenital, traumatic, pathologic, occupational, or psychologic factors. Similarly diverse are the symptoms of dysfunction at this joint, ranging from pain to structural disorder. The emphasis in this article on the role of mandibularly related muscles in the regulation of joint morphology and function may, with assurance, be extended to considerations of joint dysfunction. To the extent that TMJ dysfunction, in a specific patient, reflects dysfunction of the related functional matrix, then it would be correct to give consideration to directing therapeutic attention to these same muscles. Just as a skeletal unit can, and does, adapt both its structure and function to normal changes of its functional matrix, so a dysfunctional skeletal unit may confidently be adaptively return to normality following appropriate therapeutic alteration of the same matrix.
非临床医生对目前几种治疗颞下颌关节功能紊乱的疗法进行定性评估是不合适的。然而,值得注意的是,本文所综述的内容可能会为临床医生提供一些帮助,使他们能更深入地了解任何成功治疗方法的生物力学基础。颞下颌关节功能紊乱是一个概括性术语,涵盖了一系列不同名称的关节功能障碍。这些功能障碍可能与先天性、创伤性、病理性、职业性或心理性因素有关。同样,该关节功能紊乱的症状也多种多样,从疼痛到结构紊乱不等。本文对下颌相关肌肉在调节关节形态和功能中的作用的强调,可以肯定地扩展到对关节功能紊乱的考虑中。在特定患者中,如果颞下颌关节功能紊乱反映了相关功能基质的功能障碍,那么将治疗注意力导向这些相同的肌肉是正确的。正如一个骨骼单元能够而且确实会使其结构和功能适应其功能基质的正常变化一样,一个功能失调的骨骼单元在对相同基质进行适当的治疗性改变后,有望适应性地恢复正常。