Tourné L
Rev Belge Med Dent (1984). 1997;52(4):102-14.
The functional status of the masticatory system was investigated in a sample of 68 self-defined controls without any treatment need and 82 craniomandibular disorder patients. Among the parameters investigated were measures of mandibular mobility, the presence of joint noises and palpation tenderness of 17 muscle and 3 TMJ sites. These data allowed for calculation of Fricton's Craniomandibular Index (CMI) and Helkimo's Clinical Dysfunction Index (Di). Several socalled signs of dysfunction were found in the normal control group: 38% of the joints had some kind of noise and several muscle sites were tender to palpation (splenius capitis muscle 50%, anterior masseter and temporal muscle 45%, insertion of the trapezius muscle 40%). In addition, according to Helkimo's Di. 90% of the controls would be classified as having mild to moderate dysfunction. The high prevalence of positive signs in the control sample calls for a less rigid definition of what is called a normal craniomandibular status and refutes the a priori establishment of a narrow set of criteria for normality. Some parameters showed a highly statistically significant difference among the control and patient group (p < .001): active range of motion, deviation upon opening, pain on mandibular movement, number of tender palpation points and the CMI and Di.
在一个由68名自认为无需治疗的对照者和82名颅下颌关节紊乱症患者组成的样本中,对咀嚼系统的功能状态进行了研究。所调查的参数包括下颌运动度的测量、关节弹响的存在情况以及17块肌肉和3个颞下颌关节部位的触诊压痛情况。这些数据可用于计算弗里顿颅下颌指数(CMI)和赫尔基莫临床功能障碍指数(Di)。在正常对照组中发现了几种所谓的功能障碍体征:38%的关节有某种弹响,多个肌肉部位触诊时有压痛(头夹肌50%,咬肌前部和颞肌45%,斜方肌附着处40%)。此外,根据赫尔基莫的Di,90%的对照组会被归类为有轻度至中度功能障碍。对照样本中阳性体征的高发生率要求对所谓的正常颅下颌状态给出不那么严格的定义,并反驳了事先设定一套狭窄的正常标准。一些参数在对照组和患者组之间显示出高度统计学显著差异(p < .001):主动运动范围、开口时偏斜、下颌运动时疼痛、触诊压痛点数以及CMI和Di。