ROLE OF CONDYLAR POSITION IN TMJ DYSFUNCTION-PAIN SYNDROME
ROLE OF CONDYLAR POSITION IN TMJ DYSFUNCTION-PAIN SYNDROME
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DOI：
10.1016/0022-3913(79)90062-3
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发表时间：
1979-01-01
影响因子：
4.6
通讯作者：
WEINBERG, LA
中科院分区：
文献类型：
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作者：
WEINBERG, LA
颞下颌关节功能障碍-疼痛综合征是多种原因造成的，每个患者都有各自的“颞下颌关节功能障碍特征”。压力已被证明是与闭塞一样的相关因素。据报道，MPD 具有强烈的应激病因和安慰剂效应。然而，有人强调，根据定义，MPD 不涉及 TMJ 本身的疼痛或病理，并且（针对 MPD）研究对于确实涉及关节本身的 TMJ 功能障碍-疼痛综合征无效。根据定义，报告了 116 名患者髁突在窝中的位置，其中 55 名是急性 TMJ 功能障碍疼痛，61 名是普通实践对照。主要发现急性颞下颌关节患者髁突后退发生率为70.9%，髁突同心度（位于窝中部）仅为3.6%。在全科医生对照组中，髁突后退的发生率为 36%，髁突同心度的发生率为 23%。急性TMJ组髁突后退的发生率是对照组的两倍。相反，全科治疗对照组髁突同心度的发生率是急性颞下颌关节组的6.4倍。由此可见，髁突在窝内的位置是导致颞下颌关节功能障碍-疼痛综合征的重要因素。此外，在急性颞下颌关节功能障碍疼痛中，髁突后缩的发生频率比其他类型的移位要高得多（71%）。在一般实践控制中，髁突后缩也以足够的频率发生（36%），这表明中心关系的“经典”后缩下颌位置不一定像通常认为的那样在窝中正确定位髁突。事实上，髁突同心度（窝中部）在全科医疗对照组中普遍存在 6.4 倍，加上之前报道的证据，证实了髁突在关节窝中的最佳位置。由于髁突在窝中的位置很重要，甚至在无症状患者中也有三分之一可能会后移，因此几乎所有患者都需要进行颞下颌关节造影和咬合评估。
TMJ dysfunction-pain syndrome is multicausal, and each patient has an individual “TMJ dysfunction profile.” Stress has been shown to be a correlated factor as well as occlusion. Strong stress etiology and a placebo effect have been reported in MPD. It was emphasized, however, that MPD does not involve pain or pathology of the TMJ itself,by definition, and that research (for MPD) is not valid for TMJ dysfunction-pain syndrome which does involve the joint itself,by definition.Condylar position in the fossae of 116 patients was reported, 55 acute TMJ dysfunction-pain and 61 general practice controls. The main findings were that the incidence of condylar retrusion in the acute TMJ patients was 70.9% and condylar concentricity (in the middle of the fossae) was only 3.6%. In the general practice control group, the incidence of condylar retrusion was 36% and condylar concentricity 23%. The incidence of condylar retrusion in the acute TMJ group was twice that in the control group. Conversely, the incidence of condylar concentricity in the general practice control group was 6.4 times the occurrence in the acute TMJ group.It can be concluded that condylar position in the fossae is a significant factor in TMJ dysfunction-pain syndrome. Furthermore, condylar retrusion occurs much more frequently (71%) than other types of displacement in acute TMJ dysfunction-pain. Condylar retrusion also occurs with enough frequency in the general practice control (36%) to indicate that the “classical” retruded mandibular position of centric relation does not necessarily orient the condyles correctly in the fossae, as is commonly thought. The fact that condylar concentricity (middle of the fossae) was 6.4 times more prevalent in the general practice control group, together with previously reported evidence, confirms (that it is the optimum position in the glenoid fossae. Since the condylar position in the fossae is significant, and even in asymptomatic patients one third can be retruded, TMJ radiography and occlusal evaluation are indicated in almost all patients.