Kenworthy C R, Morrish R B, Mohn C, Miller A, Swenson K A, McNeill C
Department of Restorative Dentistry, School of Dentistry, University of California, San Francisco 94143, USA.
J Orofac Pain. 1997 Fall;11(4):328-36.
The purpose of this study was to determine if there was a difference between the temporomandibular condylar movement patterns of a symptomatic adult population and those of an asymptomatic adult population. Thirty-five volunteers who were not seeking treatment for TMD underwent two different assessments for TMD signs and symptoms: (1) a self-administered questionnaire and (2) a clinical examination. Based on the information obtained from the questionnaires, subjects were divided into "reported-symptomatic" and "reported-asymptomatic" groups. Based on the investigator's clinically evaluation of the same subjects, subjects were divided into "clinically symptomatic" and "clinically asymptomatic" groups. To compare condylar movement patterns, both groups of subjects then had their mandibular border condylar movements measured bilaterally using a sagittal recording device during maximum opening, maximum protrusion, and maximum left and right excursion movements. The patterns were separated into two broad groups, "symmetric" and "asymmetric." Symmetric gliding movements were defined as uninterrupted bilaterally mirror-like patterns of each condyle with a difference between left and right total length excursion not exceeding 2 mm during opening in the sagittal plane or horizontal plane. Our results show that 63% of the subjects who reported clinically asymptomatic for TMD demonstrated asymmetric condylar movements. However, 100% of the patients (n = 5) who reported clinically symptomatic for TMD exhibited asymmetric condylar movements. This finding suggests that, while a very high percentage of TMD subjects will have asymmetric condylar movements, condylar movements alone are not necessarily diagnostic of TMD, and the sagittal recording device may alert the clinician to abnormal movements.
本研究的目的是确定有症状的成年人群与无症状的成年人群在颞下颌关节髁突运动模式上是否存在差异。35名未寻求颞下颌关节紊乱病(TMD)治疗的志愿者接受了两种不同的TMD体征和症状评估:(1)自行填写的问卷,以及(2)临床检查。根据问卷获得的信息,受试者被分为“报告有症状”组和“报告无症状”组。根据研究者对同一受试者的临床评估,受试者被分为“临床有症状”组和“临床无症状”组。为了比较髁突运动模式,两组受试者随后在最大开口、最大前伸以及最大左右侧方运动时,使用矢状面记录装置双侧测量下颌边缘髁突运动。这些模式被分为两大类,“对称”和“不对称”。对称滑动运动被定义为每个髁突双侧不间断的镜像模式,在矢状面或水平面开口时左右总长度偏移的差异不超过2毫米。我们的结果显示,报告临床无症状的TMD受试者中有63%表现出不对称的髁突运动。然而,报告临床有症状的TMD患者(n = 5)中100%表现出不对称的髁突运动。这一发现表明,虽然很高比例的TMD受试者会有不对称的髁突运动,但仅髁突运动不一定能诊断TMD,矢状面记录装置可能会提醒临床医生注意到异常运动。