Holmlund A, Axelsson S
Department of Oral Surgery, Karolinska Institute, School of Dentistry, Huddinge, Sweden.
Acta Odontol Scand. 1994 Aug;52(4):214-8. doi: 10.3109/00016359409029049.
The prevalence of temporomandibular joint (TMJ) osteoarthrosis and synovitis was compared in 60 patients with painful chronic locking of the TMJ. Thirty patients had reduced molar occlusion, and as controls, 30 age-matched fully dentate patients were examined. Assessment comprised clinical examination (crepitation), tomography (sclerosis and erosions), and arthroscopy (cartilage involvement) of the TMJ. Arthroscopic signs of osteoarthrosis and synovitis were frequent in both groups. The highest frequency of osteoarthrosis was diagnosed by arthroscopy. With regard to clinical signs and symptoms, tomographic signs of osteoarthrosis, and arthroscopic diagnoses, no statistical differences were found between fully dentate subjects and those with reduced molar occlusion. The results do not support the concept that prevention of TMJ osteoarthrosis is an indication for prosthetic replacement of lost molars.
对60例患有颞下颌关节(TMJ)疼痛性慢性闭锁的患者,比较了颞下颌关节骨关节炎和滑膜炎的患病率。30例患者存在磨牙咬合降低,作为对照,检查了30例年龄匹配的全口牙列完整的患者。评估包括颞下颌关节的临床检查(摩擦音)、断层扫描(骨质硬化和侵蚀)以及关节镜检查(软骨受累情况)。两组中骨关节炎和滑膜炎的关节镜表现均很常见。通过关节镜检查诊断出的骨关节炎发生率最高。在临床体征和症状、骨关节炎的断层扫描征象以及关节镜诊断方面,全口牙列完整的受试者与磨牙咬合降低的受试者之间未发现统计学差异。这些结果不支持以下观点,即预防颞下颌关节骨关节炎是缺失磨牙进行修复性替换的一个指征。