Grosfeld O, Kretowicz J, Brokowski J
J Oral Rehabil. 1980 Jan;7(1):65-72. doi: 10.1111/j.1365-2842.1980.tb01464.x.
In an effort to explain the aetiology of early temporomandibular joint (TMJ) injuries, their incidence in children born by vaginal breech delivery and possible correlation with such deliveries were investigated. The study covered 156 children aged from 4 to 6 years, eighty-three of them born by vaginal breech delivery under application of the classical Mauriceau manoeuvre in seventeen cases and the Bracht manoeuvre in sixty-six. Seventy-three children delivered spontaneously in vertex presentation served as the control group. Signs of TMJ injury were found in 59.6% of the total group, the by-birth percentages being 67.5 in those after breech delivery and 50.7 in those after spontaneous delivery--the difference is statistically significant. The difference was even more significant for the more severe TMJ disorders, their percentages being in two groups respectively 48.2 and 29.7. In the children born by breech delivery the TMJ disorders were invariably attended by severe forms of distocclusion, among which the unilateral form deserves particular attention. The authors conclude that vaginal breech delivery is probably among the factors responsible for early TMJ abnormalities. They call the attention of paediatricians and obstetricians to this fact and urge examination of this joint as a very important part of oral examination in children born by vaginal breech delivery.
为了解早期颞下颌关节（TMJ）损伤的病因，对臀位阴道分娩出生儿童的TMJ损伤发生率及其与臀位阴道分娩的可能相关性进行了调查研究。该研究涵盖了156名4至6岁的儿童，其中83名通过臀位阴道分娩出生，17例采用经典的莫里斯奥手法，66例采用布拉赫特手法。73名头位自然分娩的儿童作为对照组。结果发现，TMJ损伤体征在全部研究对象中占59.6%，臀位阴道分娩儿童的发生率为67.5%，自然分娩儿童的发生率为50.7%，两者差异具有统计学意义。对于更严重的TMJ紊乱，差异更为显著，两组发生率分别为48.2%和29.7%。在臀位阴道分娩的儿童中，TMJ紊乱总是伴有严重的错牙合畸形，其中单侧错牙合畸形尤其值得关注。作者得出结论，臀位阴道分娩可能是导致早期TMJ异常的因素之一。他们提醒儿科医生和产科医生注意这一事实，并敦促在对臀位阴道分娩出生的儿童进行口腔检查时，将TMJ检查作为非常重要的一部分。
