Schellhas K P, Pollei S R, Wilkes C H
Am J Orthod Dentofacial Orthop. 1993 Jul;104(1):51-9. doi: 10.1016/0889-5406(93)70027-L.
To evaluate the relationship between internal derangement(s) of the temporomandibular joint(s) (TMJ) and disturbed facial skeleton growth (dysmorphogenesis), 128 consecutive children (103 girls, 25 boys), who were 14 years of age or younger and had undergone combined radiographic and magnetic resonance (MR) imaging studies of both TMJs, were retrospectively analyzed. Imaging studies had been performed to investigate suspected TMJ derangement because of symptoms that included, either individually or in various combinations, pain, mechanical TMJ dysfunction, and facial skeleton abnormalities, such as mandibular deficiency (particularly retrognathia) and lower facial (mandibular) asymmetry, manifested by chin deviation from the midline. Of these patients, 112 were found to have at least one internally deranged TMJ on imaging studies; in 85 patients, both TMJs were abnormal. Of the 60 retrognathic patients 56 were found to have TMJ derangement, generally bilateral and often of advanced stage. In cases of lower facial asymmetry, the chin was uniformly deviated toward the smaller or more degenerated TMJ. Both TMJs were normal in 16 patients, most of whom had normal facial structure. We conclude that TMJ derangements are both common in children and may contribute to the development of retrognathia, with or without asymmetry, in many cases.
为评估颞下颌关节（TMJ）内部紊乱与面部骨骼生长紊乱（畸形发生）之间的关系，我们对128名14岁及以下的连续儿童（103名女孩，25名男孩）进行了回顾性分析，这些儿童均接受了双侧颞下颌关节的X线和磁共振（MR）成像联合检查。进行成像研究是为了调查因以下症状怀疑存在的颞下颌关节紊乱：疼痛、颞下颌关节机械性功能障碍以及面部骨骼异常，如下颌骨发育不全（尤其是下颌后缩）和面部下部（下颌）不对称，表现为下巴偏离中线，这些症状可单独出现或多种症状组合出现。在这些患者中，成像研究发现112名患者至少有一个颞下颌关节内部紊乱；85名患者双侧颞下颌关节均异常。在60名下颌后缩患者中，56名被发现存在颞下颌关节紊乱，通常为双侧且往往处于晚期。在面部下部不对称的病例中，下巴总是偏向较小或退变更严重的颞下颌关节。16名患者双侧颞下颌关节均正常，其中大多数面部结构正常。我们得出结论，颞下颌关节紊乱在儿童中很常见，并且在许多情况下可能导致下颌后缩的发生，无论有无面部不对称。
