Diagnostic studies of Temporomandibular Joint Disorders in MRI and Arthroscopy-Correlation with Arthrography and surgical findings

MRI 和关节镜检查颞下颌关节疾病的诊断研究——与关节造影和手术结果的相关性

• 批准号: 02670907
• 负责人: KIMURA Yoshitaka
• 金额: $ 1.34万
• 依托单位: Showa 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: 1990
• 资助国家: 日本
• 起止时间: 1990 至 1991
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-02670907/
• 关键词: Temporomandibular joint (TMJ); Internal derangement; Arthrography; Magnetic resonance imaging (MRI); Arthroscopy; Conservative therapy; Manipulation; Classification; 関節造影法; MRI5; 鏡視下手術; 関節円板

In diagnosis and therapy of temporomandibular joint disorders magnetic resonance imaging(MRI)in an ideal method for visualizing hard and soft tissue structures of the temporomandibular joint(TMJ)in a short examination. MRI is useful for detection and evaluation of TMJ disk derangements, particularly in disk anterior displacement. Because of its non-irradiative diagnostics capacity, MRI has a superior value for diagnosis of uncomplicated internal derangement of the TMJ.Arthrographic technique has been very significant on diagnosis for internal derangement of TMJ. The single contrast arthrography of the lower joint space made it possible to easily and simply detect approximate position and dynamics of the joint disk. Conventional arthrography was thought as an important procedure to detect a finding of intra-articular adhesion or perforation.Arthroscopic examination was performed on the patients with closed lock of the TMJ. The intracapsular pathosis was clearly detected through the arth … More roscopy, and which enabled significant progress in diagnosis and treatment for closed lock TMJ patients.The effectivity of conservative therapy for internal derangemente with closed rock of the TMJ, confirmed in MRI were investigated. Conservative therapy was gradually applied as follows : 1. oral medication of anti-inflammatory drug and muscle relaxant, 2. mandibular manipulation or pumping manipulation technique, 3. splint therapy. In the results, about 60% were successfully unlocked by the conservative therapy.The patients with TMJ arthrosis were evaluated classified 5 types based on a classification proposed by the Japanese Society of TMJ in 1986. The iype distribution in our clinic was as follows, Type III was most commonly encountered about 45% followed by Type II Type IV, Typel and TypeV. The majority of Type 1IV were females. The cases of which bone changes of the TMJ are not so remarkable and the disks are displaced, could not be clearly determined as either Type III or Type IV. The judgment of Type II was most difficult because of its pain characters being the sole determinant.In regard to complex type, it needs further study to determine its diagnostic criteria and application. Less

在颞下颌关节疾病的诊断和治疗中，磁共振成像 (MRI) 是一种在短时间内可视化颞下颌关节 (TMJ) 硬组织和软组织结构的理想方法。 MRI 可用于检测和评估 TMJ 椎间盘紊乱，特别是椎间盘前移。 MRI由于其非辐射诊断能力，对于简单的颞下颌关节内部紊乱的诊断具有较高的价值。关节造影技术对于颞下颌关节内部紊乱的诊断具有重要意义。下关节空间的单一对比关节造影术可以轻松简单地检测关节盘的大致位置和动态。传统的关节造影术被认为是检测关节内粘连或穿孔的重要手段。对颞下颌关节闭合锁的患者进行关节镜检查。通过关节镜检查可以清楚地检测到囊内病变，这使得闭锁型颞下颌关节患者的诊断和治疗取得了重大进展。研究了经 MRI 证实的闭锁型颞下颌关节内部紊乱保守治疗的有效性。逐渐采用保守疗法：1.口服抗炎药、肌松药；2.下颌手法或泵手法；3.夹板疗法。结果，约60%通过保守治疗成功解锁。根据日本颞下颌关节学会1986年提出的分类，将颞下颌关节病患者分为5种类型。我们诊所的类型分布如下，III型最常见，约占45%，其次是II型IV型、I型和V型。大多数 1IV 型是女性。颞下颌关节骨性改变不明显且椎间盘移位的病例，不能明确判定为Ⅲ型还是IV型。 II型的判断最为困难，因为其疼痛特征是唯一的决定因素。对于复杂型，还需要进一步研究确定其诊断标准和应用。较少的

项目成果

Kimura, Y. and Sakamaki, H.: "Treatment andclassification proposed by Japanese Society of Temporomandibular Joint." J. Showa Univ. Dent. Soc.12. (1992)

Kimura, Y. 和 Sakamaki, H.：“日本颞下颌关节学会提出的治疗和分类。”

Kimura, Y. and Sakamaki, H.: "Diagnostic studies of temporo mandibular joint disorders in MR imaging and arthroscopy." J. Jpn Soc T. M. J.4. (1992)

Kimura, Y. 和 Sakamaki, H.：“磁共振成像和关节镜检查中颞下颌关节紊乱的诊断研究。”

木村 義孝,坂巻 秀明: "顎関節症における症型分類と治療" 顎関節学会雑誌. 4巻1号. (1992)

Yoshitaka Kimura，Hideaki Sakamaki：“颞下颌关节疾病的分类和治疗”，颞下颌关节学会杂志，第 4 卷，第 1 期（1992 年）。

木村 義孝,坂巻 秀明: "MRIおよび関節鏡による顎関節疾患の診断" 昭和歯学会雑誌. 12巻3号. (1992)

Yoshitaka Kimura、Hideaki Sakamaki：“利用 MRI 和关节镜诊断颞下颌关节疾病”，昭和牙科学会杂志，第 12 卷，第 3 期（1992 年）。