de Leeuw R, Boering G, Stegenga B, de Bont L G
Department of Oral and Maxillofacial Surgery, University Hospital, Groningen, The Netherlands.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995 Mar;79(3):382-92. doi: 10.1016/s1079-2104(05)80233-1.
The aim of this study was to evaluate with radiographs the long-term status of temporomandibular joints that were treated nonsurgically for reducing disk displacement (group 1) or permanent disk displacement (group 2) 30 years ago. Transcranial and transpharyngeal radiographs were made before (T1), 2 to 4 years after (T2), and 30 years after (T3) nonsurgical treatment in 65 former patients with temporomandibular joint osteoarthrosis. To control the results for aging 35 matched subjects (group 3) underwent the same radiographic examination. The number and severity of radiographically visible degenerative changes increased significantly from T1 through T2 to T3 in group 1 and in group 2. The increase in these changes was not simply caused by aging, because in approximately three quarters of the temporomandibular joints in group 3, no radiographically visible degenerative changes were found. At all occasions group 2 showed significantly more severe changes than group 1. At T3 in 64% of the temporomandibular joints in group 1, no or only slight radiographically visible degenerative changes were observed, whereas in 86% of the temporomandibular joints in group 2, moderate to severe changes were observed. A persisting reducing disk displacement in part of the temporomandibular joints in group 1 might explain this significant difference. In 79% of the temporomandibular joints with moderate to severe radiographically visible degenerative changes at T1, no or only slight progression in the extent of these changes was seen between T2 and T3. Apparently a radiographically stable end stage may be reached within a few years after permanent displacement in most cases. It was concluded that in temporomandibular joints with reducing disk displacement, no or only slight radiographically visible degenerative changes develop, even if this condition persists for several decades. On the other hand, in temporomandibular joints with permanent disk displacement, radiographically visible degenerative changes are extensive in the vast majority of cases.
本研究的目的是通过X线片评估30年前接受非手术治疗以减少盘移位（第1组）或永久性盘移位（第2组）的颞下颌关节的长期状况。对65例曾患颞下颌关节骨关节炎的患者在非手术治疗前（T1）、治疗后2至4年（T2）以及治疗后30年（T3）拍摄经颅和经咽X线片。为了控制衰老对结果的影响，35名匹配的受试者（第3组）接受了相同的X线检查。第1组和第2组中，从T1到T2再到T3，X线可见的退行性改变的数量和严重程度显著增加。这些改变的增加并非仅仅由衰老引起，因为在第3组中约四分之三的颞下颌关节未发现X线可见的退行性改变。在所有检查阶段，第2组的改变均明显比第1组严重。在T3时，第1组64%的颞下颌关节未观察到或仅观察到轻微的X线可见的退行性改变，而在第2组86%的颞下颌关节观察到中度至重度改变。第1组部分颞下颌关节持续存在盘移位减少可能解释了这一显著差异。在T1时具有中度至重度X线可见退行性改变的颞下颌关节中，79%在T2和T3之间这些改变的程度未出现或仅出现轻微进展。显然，在大多数情况下，永久性移位后的几年内可能会达到X线稳定的终末期。研究得出结论，在盘移位减少的颞下颌关节中，即使这种情况持续数十年，也不会出现或仅出现轻微的X线可见的退行性改变。另一方面，在永久性盘移位的颞下颌关节中，绝大多数情况下X线可见的退行性改变广泛存在。
