Perry H T
Department of Orthodontics, Northwestern University Dental School, Chicago, Illinois, USA.
Ann Acad Med Singap. 1995 Jan;24(1):163-7.
Sixty years ago, James Costen, an otolaryngologist, described a group of signs and symptoms of jaw and ear disturbances that he related to loss of mandibular posterior teeth and lower jaw overclosure. His recommended therapy was to "build up the bite". This review of the literature since that time presents evolving concepts that have primarily refuted Costen's original concepts and have stressed the aetiologic role of muscle function, psychosocial factors, and individual parafunctional habits related to the stress of daily life. Present treatment protocol for temporomandibular joint dysfunction emphasizes the need for an accurate diagnosis by the dentist or physician--as to whether the problem is arthrogenous, neurogenous, myogenous, or a combination of these--prior to the initiation of any therapy.
六十年前，耳鼻喉科医生詹姆斯·科斯坦描述了一组与下颌后牙缺失和下颌过度闭合相关的颌部及耳部紊乱的体征和症状。他推荐的治疗方法是“恢复咬合”。自那时起对文献的回顾呈现出不断演变的概念，这些概念主要反驳了科斯坦的原始概念，并强调了肌肉功能、心理社会因素以及与日常生活压力相关的个体副功能习惯的病因学作用。目前颞下颌关节紊乱的治疗方案强调，在开始任何治疗之前，牙医或医生需要进行准确诊断——判断问题是关节源性、神经源性、肌源性还是这些因素的组合。
