Friedman M H
Department of Dentistry, Westchester County Medical Center, Valhalla, New York, USA.
Gen Dent. 1997 May-Jun;45(3):282-5.
The hypomobile (restricted) temporomandibular joint (TMJ) is usually caused by a restricted joint capsule or by an anteriorly displaced disk. Here, painful unilateral hypomobility (19 mm jaw opening), with normal disk position, caused by voluntary immobilization after a dental procedure, was the presenting symptom. Management included inflammation control, TMJ manipulation (mobilization), and lateral pterygoid muscle relaxation. Inflammation and pain were alleviated by nonsteroidal anti-inflammatory drugs (NSAIDs) and local TMJ ice massage. TMJ mobilization was performed at every visit, to tear joint capsule adhesions and to realign collagen fibers. Exercise consisted mainly of resistive opening (the patient resists an upward force applied to the chin), with the jaw maintained at full opening. This produced lateral pterygoid muscle relaxation at full length, aiding in the restoration of a pain-free 44 mm opening.
活动受限（受限）的颞下颌关节（TMJ）通常由关节囊受限或盘状软骨前移引起。在此病例中，在牙科手术后因自愿固定导致的疼痛性单侧活动受限（开口19毫米），且盘状软骨位置正常，是主要症状。治疗措施包括控制炎症、进行颞下颌关节手法治疗（松动术）以及放松翼外肌。通过非甾体类抗炎药（NSAIDs）和局部颞下颌关节冰敷按摩缓解炎症和疼痛。每次就诊时都进行颞下颌关节松动术，以撕开关节囊粘连并使胶原纤维重新排列。锻炼主要包括抗阻开口（患者抵抗施加于下巴的向上力量），使下颌保持完全张开。这可使翼外肌在全长范围内放松，有助于恢复无痛的44毫米开口。
