Zhang X N, Nishiyama H, Murakami S, Fuchihata H
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Osaka University, Japan.
Dentomaxillofac Radiol. 1998 Sep;27(5):279-86. doi: 10.1038/sj/dmfr/4600364.
To analyse the condylar movements of patients with temporomandibular disorders and investigate the mutual interaction between both temporomandibular joints (TMJs) by comparing bilateral simultaneous videofluorography with the disk position on MRI.
Fifty-two patients who had been diagnosed as having internal derangement in one or both TMJs on the base of the clinical symptoms underwent bilateral simultaneous videofluorography and MRI. The TMJs were classified from the MRI into three categories: superior disk position (SDP), reducing disk displacement (RDD) and nonreducing disk displacement (NDD). Condylar movements of the TMJs were analysed from the videofluorography and correlated with the MR diagnoses.
The range of condylar movement of NDD joints was significantly shorter than that of SDP or RDD joints at maximum mouth opening (P < 0.001), but not at maximum protrusion and lateral protrusion. Based on the sagittal condylar path during maximum mouth opening and closing, three patterns of condylar movement were identified: normal, deflected and short. Sixty-nine per cent of the normal pattern were SDP, 55% of the deflected RDD and 77% of the short NDD. The condylar movement of a NDD or RDD joint could influence the range and pattern of movement of the contralateral joint.
Analysis of condylar movement was helpful in assessing the state of the disk because they were closely related. The range and pattern of condylar movement of both TMJs were mutually interrelated. Patients with signs and symptoms of internal derangement should have both sides examined for an accurate and complete diagnosis.
分析颞下颌关节紊乱病患者的髁突运动，并通过将双侧同步视频荧光造影与MRI上的盘位置进行比较，研究双侧颞下颌关节（TMJ）之间的相互作用。
52例根据临床症状被诊断为单侧或双侧TMJ内紊乱的患者接受了双侧同步视频荧光造影和MRI检查。根据MRI将TMJ分为三类：盘前移位（SDP）、可复性盘移位（RDD）和不可复性盘移位（NDD）。从视频荧光造影分析TMJ的髁突运动，并与MR诊断结果相关联。
NDD关节在最大张口时的髁突运动范围明显短于SDP或RDD关节（P < 0.001），但在最大前伸和侧方运动时无明显差异。根据最大张口和闭口时的矢状髁突路径，确定了三种髁突运动模式：正常、偏斜和缩短。正常模式中69%为SDP，偏斜模式中55%为RDD，缩短模式中77%为NDD。NDD或RDD关节的髁突运动可影响对侧关节的运动范围和模式。
髁突运动分析有助于评估盘的状态，因为它们密切相关。双侧TMJ的髁突运动范围和模式相互关联。有内紊乱体征和症状的患者应双侧检查以获得准确和完整的诊断。
