Sato H, Fujii T, Kitamori H
Dept. of Removable Prosthodontics, Nagasaki University, School of Dentistry, Japan.
Cranio. 1997 Jul;15(3):229-35. doi: 10.1080/08869634.1997.11746016.
Ninety-one patients with unilateral temporomandibular disorders (TMD) were examined using submento-vertex projection radiography and lateral and frontal temporomandibular joint (TMJ) tomography. A comparison between clinical and radiographic findings was made to verify whether patients with TMJ osteoarthritis/osteoarthrosis (OA) tend to have high horizontal condylar angles and to determine the clinical significance of the horizontal condylar angle in the diagnosis of TMD. Our survey results did not confirm higher horizontal condylar angles in condyles with radiographic abnormal findings than in those with normal. However, significantly higher angles were observed in symptomatic TMJs with pain on movement/palpation than in those without (P < 0.05). A tendency toward higher angles was also observed in patients with other clinical findings such as TMJ sound on the symptomatic side and limitation of mouth opening, but there were no significant differences. Thus, the clinical significance of measuring the horizontal condylar angle was demonstrated. Careful diagnosis and treatment is therefore recommended with patients for whom the horizontal condylar angle is high.
91例单侧颞下颌关节紊乱病（TMD）患者接受了颏顶位投照X线摄影以及颞下颌关节（TMJ）侧位和正位断层扫描检查。对临床检查结果与影像学检查结果进行比较，以验证颞下颌关节骨关节炎/骨关节病（OA）患者是否倾向于有较高的髁突水平角，并确定髁突水平角在TMD诊断中的临床意义。我们的调查结果并未证实，影像学检查有异常表现的髁突其水平角高于正常髁突。然而，有运动/触诊疼痛症状的TMJ的水平角显著高于无此症状者（P<0.05）。在有其他临床症状如患侧TMJ弹响和张口受限的患者中也观察到有角度增大的趋势，但无显著差异。因此，髁突水平角测量的临床意义得到了证实。因此，对于髁突水平角较高的患者，建议进行仔细的诊断和治疗。
