顎機能異常者における下顎頭の変動に関する臨床適研究

颌骨功能异常患者下颌髁突变化的临床相关研究

• 批准号: 63570912
• 负责人: 野村 修一
• 金额: $ 1.02万
• 依托单位: Niigata 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: 1988
• 资助国家: 日本
• 起止时间: 1988 至 无数据
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-63570912/
• 关键词: 顎機能異常; 相反性クリック; 間接円板前方転位; 顆頭運動; 両側顆頭の協調性; 運動経路の屈曲; クリック発生位置

本研究の目的はあこせ関節症を1.咀嚼筋に障害が限局しているもの、2.顎関節部軟組織に障害が及ぶもの、3.顎関節部硬組織に障害がおよぶもの、に大別した際の各病型における無顎運動、とりわけ顆頭運動の特徴を明らかにするための診断方法を検討することである。3病型のうち、顎関節部軟組織への障害の有無はその後の治療法が大きく異なることから、その顆頭運動の特徴を明らかにすることは鑑別診断で特に重要である。そこで今回、相反性クリックを認め、顎関節造影所見で関節円板の前方転位と診断された6症例の習慣的開閉口、前方滑走運動での顆頭の動態とクリック発生位置を分析し、以下の結果を昭和63年度日本保綴歯科学会関東支部学術大会で報告した。1.相反性クリック症例の顆頭運動の特徴、特にクリック時の顆賀の動態が次の分析から診断できた。(1)顆頭の前方移動量の制限の有無、(2)運動経路上の急激な屈曲の有無、(3)両側顆頭運動の円滑さと協調性、(4)顆頭運動の速度パターン、特に、(3)はクリック時の時間的対応のみならず、患側顆頭での運動の停滞と直後の急激な移動が対側顆頭に与える影響の把握や、クリック発生原因の推定などの情報が得られ、診断に有効であった。2.クリックの発生位置を分析した結果より、(1)クリック時の切歯点での開口量から間接円板の前方転位の程度、すなわち病態の進行を診断するのは必ずしも適切とは言えない。(2)クリック発生時の顆頭点の移動距離を知るには開口運動よりも前方滑走運動時の切歯点移動量を測定することが臨床上有効と考えられた。したがって、顎間接部軟組織の障害程度を診断するには、クリック発生(1)に加え、顆頭の運動経路の屈曲程度を診断するには、クリック発生(1)に加え、顆頭の運動経路の屈曲程度などから運動の様相を捉える必要があり、現在その分析方法を検討している。

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