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矢状位髁突运动模式对颞下颌关节内紊乱症的诊断准确性

Diagnostic accuracy of sagittal condylar movement patterns for identifying internal derangement of the temporomandibular joint.

作者信息

Ozawa S, Tanne K

机构信息

Department of Orthodontics, Hiroshima University School of Dentistry, Japan.

出版信息

J Orofac Pain. 1997 Summer;11(3):222-31.

PMID:9610312
Abstract

The aim of this study was to compare sagittal condylar movement patterns (SCMP, Axiograph) and high-field (1.5 T) magnetic resonance imaging (MRI) findings of the temporomandibular disorders. One hundred forty-one patients with TMD signs and/or symptoms were selected for this study. SCMP was categorized into six patterns: normal, figure-eight (early/intermediate/late), limited, and other irregularities. The MRI findings of TMJ internal derangement were defined as one of five stages according to Wilkes criteria and then compared to the SCMP findings. Among normal SCMP, MRI revealed disc displacement in 27%. Sixty-three percent of figure-eight SCMP were regarded as stage I or II with reducible disc displacement. The sensitivity and specificity of SCMP for detecting TMJ internal derangement were 0.79 and 0.62, respectively. The point of deflection in figure-eight SCMP and the degree of disc displacement were not significantly related. However, a significant relationship was observed between the point of deflection in figure-eight SCMP and any type of disc deformation (chi-square = 9.80, P = .002). Thus, SCMP is not yet accurate enough for diagnosing a TMJ condition, especially in the case of chronic and/or adaptive internal derangement.

摘要

本研究的目的是比较髁突矢状运动模式(SCMP,轴描记仪)和颞下颌关节紊乱病的高场强(1.5T)磁共振成像(MRI)表现。本研究选取了141例有颞下颌关节紊乱病体征和/或症状的患者。SCMP分为六种模式:正常、8字形(早期/中期/晚期)、受限及其他不规则模式。根据Wilkes标准,将颞下颌关节内紊乱的MRI表现定义为五个阶段之一,然后与SCMP表现进行比较。在正常SCMP中,MRI显示27%存在盘移位。8字形SCMP中有63%被视为I期或II期,盘移位可复。SCMP检测颞下颌关节内紊乱的敏感性和特异性分别为0.79和0.62。8字形SCMP中的偏斜点与盘移位程度无显著相关性。然而,在8字形SCMP中的偏斜点与任何类型的盘变形之间观察到显著相关性(卡方=9.80,P=0.002)。因此,SCMP对于诊断颞下颌关节疾病还不够准确,尤其是在慢性和/或适应性内紊乱的情况下。

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