Fundamental and clinical study on joint noize in internal derangement of the temporomandibular joint

颞下颌关节内部紊乱的关节噪声的基础与临床研究

• 批准号: 05671666
• 负责人: SEGAMI Natsuki
• 金额: $ 1.34万
• 依托单位: KYOTO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1993
• 资助国家: 日本
• 起止时间: 1993 至 1994
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-05671666/
• 关键词: temporomandibular joint; internal derangement; joint noize; pathology; therapeutic modality; MRI; 関節円板前方転位; 臨床的検討; 基礎的検討

In clinical investigation, MRI in combination with 3 dimensional imaging and Turbo-FLASH method was attempted to clarify the detail pathology in internal derangement of the temporomandibular joint. In comparison MRI disk shape, type of disk displacement) with clinical signs and symptoms, showed 1) minor deformity of the disk in click cases, 2) disk reduction point was correlation with clinical signs, 3) tend of more anterior of disk reduction point in intermittent lock cases. Simple diagnostic arthroscopy developed to detect intraarticular pathology realized the high frequency of adhesion in internal derangement, which should be taken off. In therapeutic modality of jont noize, the procedures and outcomes in both conservative and surgical treatments, as well as, definitions in surgery for joint noize were demonstrated. In fundamental investigations, postoperative healing process in several arthroscopic surgeries were identified in experimental animal studies. Especially, cartilage regeneration was poor following arthroscopic eminoplasty, arthroscopic suturing and diskectomy. Moreover, some irreversible affects were shown in these operations, which can help the appropriate indication of surgical intervention for jont noize of temporomandibular joint disorders.

在临床研究中，我们尝试用MRI结合三维成像和Turbo-FLASH技术来阐明颞下颌关节内紊乱病的详细病理。MRI椎间盘形态、椎间盘移位类型与临床症状、体征的比较显示：1）喀喇音病例椎间盘变形较小; 2）椎间盘复位点与临床症状相关; 3）间歇性交锁病例椎间盘复位点更靠前。为检测关节内病理而开发的简单诊断性关节镜发现内部紊乱中粘连的频率很高，应将其取下。在关节噪声的治疗模式中，阐述了保守治疗和手术治疗的程序和结果，以及关节噪声的手术定义。在基础研究中，在实验动物研究中确定了几种关节镜手术的术后愈合过程。尤其是关节镜下疝成形术、关节镜下椎间盘切除术和椎间盘切除术后，软骨再生较差。同时，这些手术也显示了一些不可逆的影响，这对颞下颌关节紊乱病关节突畸形的手术治疗有一定的指导意义。

项目成果

楠本貴司 他: "顎関節疾患に対する関節鏡視下結節形成術の経験" 日本口腔外科学会雑誌. 39. 458-461 (1993)

Takashi Kusumoto 等：“关节镜结节成形术治疗颞下颌关节疾病的经验”日本口腔颌面外科学会杂志 39. 458-461 (1993)。

N.Segami, et al: "Development of simplified diagnostic arthroscopy of the temporomandibular joint." Dentistry in Jpn.30. 87-91 (1993)

N.Segami 等人：“颞下颌关节简化诊断关节镜的开发。”

N.Segami.: "Arthroscopic antero-lateral capsular release for internal derangement of the temporomandibular joint." Arthroscopy.18. 105-110 (1993)

N.Segami.：“关节镜前外侧囊松解术治疗颞下颌关节内部紊乱。”

K.Miyaki,et al: "Histological and immunohistochemical studies of the articular cartilage after experimental discectomy of the temporomandibular joint in rabbits" Journal of Oral Rehabilitation. 21. 299-310 (1994)

K.Miyaki 等人：“兔颞下颌关节实验性椎间盘切除术后关节软骨的组织学和免疫组织化学研究”口腔康复杂志。

瀬上 夏樹: "顎関節症の症型分類とその診断、治療法について" 岡山県歯科医師会会報. 555. 6-14 (1993)

濑上夏树：“颞下颌关节疾病的分类、诊断和治疗方法”冈山县牙科协会公报 555. 6-14 (1993)。