Chen C W, Boulton J L, Gage J P
Department of Dentistry, University of Queensland.
Aust Dent J. 1995 Apr;40(2):71-8. doi: 10.1111/j.1834-7819.1995.tb03119.x.
This pilot study was undertaken to correlate clinical and MRI diagnoses in seven symptomatic TMJ dysfunction patients and to account, if possible, for the clinical improvement in the signs and symptoms after the use of a maxillary stabilizing splint. The symptomatic TMJs were evaluated by means of MRI prior to splint insertion. Sagittal open/closed, and coronal closed images were obtained with a 0.3 T Fonar MR Scanner. A follow-up MRI was taken after three months of splint therapy for the purposes of a comparative study. All subjects responded positively even at the early phase of splint treatment. By the end of the three month period, six subjects experienced full remission of pain in the TMJ and associated masticatory muscles with one subject experiencing only partial remission following therapy. Baseline MRI study revealed that only three subjects had anterior disc displacement while the other four subjects had normal disc/condyle relationships and morphology. In the follow-up MRI study, there were no signs of recapture of the three anteriorly displaced discs despite there being evidence of improved jaw movement and remission of pain symptoms. The use of MRI in this preliminary study indicates that some but not all TMJ pain dysfunction syndromes are caused by internal derangements of the joint. A larger MRI study using the same clinical parameters is indicated for future research.
本初步研究旨在关联7例有症状的颞下颌关节紊乱患者的临床诊断与MRI诊断，并尽可能解释使用上颌稳定咬合板后体征和症状的临床改善情况。在插入咬合板之前，通过MRI对有症状的颞下颌关节进行评估。使用0.3T的Fonar MR扫描仪获取矢状位开口/闭口以及冠状位闭口图像。为了进行对比研究，在咬合板治疗三个月后进行了随访MRI检查。所有受试者即使在咬合板治疗的早期阶段也有积极反应。在三个月疗程结束时，6名受试者的颞下颌关节及相关咀嚼肌疼痛完全缓解，1名受试者治疗后仅部分缓解。基线MRI研究显示，只有3名受试者存在关节盘前移位，其他4名受试者的关节盘/髁突关系及形态正常。在随访MRI研究中，尽管有下颌运动改善和疼痛症状缓解的证据，但3个前移位关节盘没有复位迹象。本初步研究中MRI的使用表明，部分而非全部颞下颌关节疼痛功能紊乱综合征是由关节内部紊乱引起的。未来研究建议使用相同临床参数进行更大规模的MRI研究。
