de Filippis C, Osti L, Osti R, Marioni G, Pedace E
Clinica Ortopedica, Università di Udine.
Acta Otorhinolaryngol Ital. 1998 Apr;18(2):111-5.
Algo-dysfunctional syndrome (ADS) of the temporo-mandibular joint (TMJ) is frequently encountered and, since its clinical expression is extremely polymorphic, it is often misdiagnosed. As there are many causes for ADS, even in a single patient, in line with the most recent interpretations found in the literature, an attempt was made to determine how important the lack of muscular coordination is in the onset of clinical symptoms. The study was conducted on 48 patients (32 females, 16 males, age range 17-68 years, average age 41.7 years) with ADS, clinically diagnosed according to the criteria defined by Rendell et al. The patients belonged to three distinct groups: -Group 1: patients with ADS of articular origin (9 cases); -Group 2: patients with ADS of dental and/or periodontal origin (18 cases); -Group 3: patients with ADS for which there was no apparent cause (21 cases). All patients were treated with a rehabilitation protocol aimed at eliminating the muscle spasm and restoring correct coordination. The results obtained showed that conservative treatment to resolve the muscle spasm gave positive results in 69% of the cases. The patients with concomitant articular pathology proved the least responsive to treatment. It was, therefore, considered likely that the main cause for clinical expression of this pathology is the muscle spasm itself. On this basis it can be concluded that muscular rehabilitation of the TMJ is valid in the treatment of ADS as it has proved able to break the vicious cycle of symptoms at the base of this pathology.
颞下颌关节功能紊乱综合征(ADS)很常见,由于其临床表现极具多样性,常被误诊。由于ADS有多种病因,即使在单个患者中也是如此,根据文献中的最新解释,我们试图确定肌肉协调性缺失在临床症状发作中的重要程度。该研究对48例ADS患者进行(32名女性,16名男性,年龄范围17 - 68岁,平均年龄41.7岁),根据Rendell等人定义的标准进行临床诊断。患者分为三个不同组:- 第1组:关节源性ADS患者(9例);- 第2组:牙源性和/或牙周源性ADS患者(18例);- 第3组:无明显病因的ADS患者(21例)。所有患者均接受旨在消除肌肉痉挛并恢复正确协调性的康复方案治疗。所得结果表明,解决肌肉痉挛的保守治疗在69%的病例中取得了积极效果。伴有关节病变的患者对治疗反应最差。因此,认为这种病理临床表型的主要原因可能是肌肉痉挛本身。在此基础上可以得出结论,颞下颌关节的肌肉康复在ADS治疗中是有效的,因为它已证明能够打破这种病理症状的恶性循环。