De Laat A
Département d'Odontologie, Université Catholique de Leuven.
Rev Belge Med Dent (1984). 1997;52(4):115-23.
Parallel to the construction of better classifications and the identification of subgroups of temporomandibular disorders, an important development has taken place in research concerning its etiology. The etiological factors implied in muscle problems refer to more generalised disorders as myofascial pain syndrome and fibromyalgia. The role of occlusal and articular factors has been brought down to realistic proportions, indicating a minor contribution. Similarly, doubt has arisen concerning the existence of a vicious cycle of pain/spasm/pain. With regard to internal derangements, emphasis has been put on the high prevalence in an otherwise normal population and the fluctuating character of the symptom. Also here, developments point towards constitutional and systemic factors, more than local influences. Trauma, however, seems to play an increasing role. The development of osteoarthrosis has been studied more in depth revealing local processes of inflammation, neurogenic inflammation and the existence of specific markers which might be important in the future. The relationship between disc derangement and the development of osteoarthrosis remains unclear.
在构建更好的分类体系以及确定颞下颌关节紊乱症亚组的同时，关于其病因的研究也取得了一项重要进展。肌肉问题中所涉及的病因因素指向更广泛的病症，如肌筋膜疼痛综合征和纤维肌痛。咬合和关节因素的作用已被降至合理水平，表明其贡献较小。同样，对于疼痛/痉挛/疼痛恶性循环的存在也产生了疑问。关于内部紊乱，重点已放在在其他方面正常的人群中的高患病率以及症状的波动特征上。在此方面，发展趋势也指向体质和全身因素，而非局部影响。然而，创伤似乎正发挥着越来越大的作用。骨关节炎的发展已得到更深入研究，揭示了局部炎症过程、神经源性炎症以及特定标志物的存在，这些在未来可能很重要。椎间盘紊乱与骨关节炎发展之间的关系仍不明确。
