Articular disc displacement in mandibular asymmetry patients.
Articular disc displacement in mandibular asymmetry patients.
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DOI：
10.11480/jmds.510110
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发表时间：
2004-03
影响因子：
--
通讯作者：
B. Buranastidporn;M. Hisano;K. Soma
中科院分区：
文献类型：
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作者：
B. Buranastidporn;M. Hisano;K. Soma
下颌不对称的关节盘移位(TMJ)和内错位(ID)的机制尚不清楚。本研究从临床和生物力学两个方面研究了椎间盘移位的程度和方向及其与垂直不对称性的关系。采用MRI对31例下颌骨不对称患者的关节盘移位进行了回顾性研究。用垂直不对称度研究移位侧和对侧TMJ的关节盘移位的程度和方向。在此基础上，建立了咬合状态下包括TMJ和上颌牙齿在内的整个下颌骨的三维有限元模型，模拟咬合状态下关节盘的位移。移位侧与对侧位移位向有显著差异。关节盘在移位侧有更多移位的倾向，即使在轻微的垂直不对称程度上也是如此。移位的程度与不对称的程度相关。MR结果与有限元模型预测的椎间盘位移趋势一致。我们认为，下颌骨不对称引起的应力分布方向的扰动是导致关节盘移位的机制之一。
Mechanisms of disc displacement in temporomandibular joint (TMJ) internal derangement (ID) in mandibular asymmetry have not been clearly defined. This study examines the degree and direction of disc displacement and their relationship with vertical asymmetry in terms of both clinical and biomechanical aspects. A retrospective study of disc displacement was performed in 31 mandibular asymmetry patients using MR imaging. The degree and direction of disc displacements on the shifted side and contralateral side TMJ were investigated with the degree of vertical asymmetry. Furthermore, three-dimensional finite element models of entire mandible include TMJ and maxillary teeth in occlusion were created to simulate displacement of the articular disc during clenching condition. The direction of displacement on the shifted side and contralateral side were significantly different. Articular disc has tendencies to displace more on the shifted side even in mild degree of vertical asymmetry. The degree of displacement was correlated with the amount of asymmetry. The MR results were consistent with the tendencies of disc displacement predicted from the finite element models. We suggest that disturbance in the direction of stress distribution through asymmetry of the mandible is one of the mechanisms related to disc displacement.