Maxwell M F, Farman A G, Haskell B S, Yancey J M
Division of Radiology and Imaging Sciences, University of Louisville, School of Dentistry, Kentucky 40292, USA.
Cranio. 1995 Jan;13(1):15-21. doi: 10.1080/08869634.1995.11678036.
Controversy exists in the literature concerning the association between the radiographic and the clinical features of the temporomandibular dysfunction (TMD). Hence, this study reinvestigated possible correlations between radiographically detected asymmetries and the clinical signs and symptoms of TMD. Complete clinical and radiographic records were gathered from 52 patients sequentially referred for corrected angle tomographs of the temporomandibular joint (TMJ). Measurements from submentovertex (SMV), lateral and posterior-anterior (PA) cephalographs and corrected angle parasagittal tomographs and recorded clinical signs and symptoms of TMD were the data inputs. Significant findings were as follows: a) as the discrepancy in the posterior condyle to pogonion measurement increased, the pogonion and both maxillary and mandibular incisors shifted laterally towards the shorter side; b) as the ANB angle increased, so did the difference in condylar angle measurements between the two condyles; c) the side with the larger condylar angle was positioned forward on the SMV; and d) a perpendicular bisector (Marmary's Centerline) of the line drawn between the right and left foramen spinosum was found to be a reliable baseline reference for SMV analyses. No statistically significant relation was found linking specific signs and symptoms of TMD to maxillofacial asymmetries recorded on SMV, lateral or PA cephalographs. None of the radiographic signs studied were found to be good predictors of specific signs and symptoms in TMD.
关于颞下颌关节紊乱病（TMD）的影像学特征与临床特征之间的关联，文献中存在争议。因此，本研究重新调查了影像学检测到的不对称性与TMD临床体征和症状之间可能存在的相关性。从52例因颞下颌关节（TMJ）矫正角度断层扫描而依次转诊的患者中收集了完整的临床和影像学记录。颏顶位（SMV）、侧位和后前位（PA）头颅侧位片以及矫正角度矢状旁断层扫描的测量结果以及记录的TMD临床体征和症状作为数据输入。重要发现如下：a）随着髁突后部至颏前点测量值的差异增加，颏前点以及上颌和下颌切牙均向较短侧横向移动；b）随着ANB角增加，两侧髁突角测量值的差异也增加；c）髁突角较大的一侧在颏顶位片上位于前方；d）发现左右棘孔之间连线的垂直平分线（马尔马里中线）是颏顶位片分析的可靠基线参考。未发现TMD的特定体征和症状与颏顶位片、侧位或后前位头颅侧位片上记录的颌面不对称性之间存在统计学上的显著关系。所研究的影像学征象均未被发现是TMD特定体征和症状的良好预测指标。
