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颞下颌关节和颈椎疾病中口颌系统的症状。

Symptoms of the stomatognathic system in temporomandibular and cervical spine disorders.

作者信息

de Wijer A, Steenks M H, Bosman F, Helders P J, Faber J

机构信息

Department of Oral-Maxillofacial Surgery, Utrecht University, The Netherlands.

出版信息

J Oral Rehabil. 1996 Nov;23(11):733-41. doi: 10.1046/j.1365-2842.1996.00427.x.

Abstract

This study was performed to assess the prevalence of signs and symptoms of temporomandibular disorders (TMD) in patients with cervical spine disorders (CSD) and to compare patients with CSD and subgroups of patients with TMD with regard to the results of orthopaedic tests of the stomatognathic system. A group of 103 consecutive patients with signs and symptoms of CSD and a group of 111 consecutive patients with TMD were examined. All subgroups of TMD patients showed a significantly smaller range of motion than the CSD patients. Patients with TMD had limited mouth opening (< 40 mm) on active and passive mouth opening more often than CSD patients. TMD patients with myogenous problems reported oral habits more often than CSD patients, although no objective differences between CSD and TMD patients were found. Subgroups of TMD patients reported joint sounds, and pain on palpation and joint play tests of the temporomandibular joint (TMJ) more frequently than CSD patients. Joint sounds on active movements, pain on palpation of the TMJ, and pain on joint play tests correctly classified 82% of the patients with TMD and 72% of the patients with CSD. In spite of the biomechanical and anatomical relationship between the neck and the stomatognathic system, the results of the study show that CSD patients have signs and symptoms of TMD comparable with those of the adult Dutch population. It was concluded that the function of the masticatory system should be evaluated in patients with neck complaints in order to rule out a possible involvement of the masticatory system.

摘要

本研究旨在评估颈椎疾病(CSD)患者颞下颌关节紊乱病(TMD)的体征和症状患病率,并比较CSD患者与TMD患者亚组在口腔颌面部系统骨科检查结果方面的差异。对一组103例连续的有CSD体征和症状的患者以及一组111例连续的TMD患者进行了检查。所有TMD患者亚组的活动范围均明显小于CSD患者。TMD患者在主动和被动开口时出现张口受限(<40mm)的情况比CSD患者更常见。有肌源性问题的TMD患者比CSD患者更常报告有口腔习惯,尽管在CSD和TMD患者之间未发现客观差异。TMD患者亚组比CSD患者更频繁地报告颞下颌关节(TMJ)的关节弹响、触诊疼痛和关节活动度检查疼痛。主动运动时的关节弹响、TMJ触诊疼痛和关节活动度检查疼痛能正确区分82%的TMD患者和72%的CSD患者。尽管颈部与口腔颌面部系统之间存在生物力学和解剖学关系,但研究结果表明,CSD患者的TMD体征和症状与成年荷兰人群相当。研究得出结论,对于有颈部不适的患者,应评估咀嚼系统的功能,以排除咀嚼系统可能存在的问题。

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