The Database with Expert System for Differential and Etiological Diagnosis of CMD

正确的鉴别诊断和病因诊断是颅下颌关节紊乱病治疗成功的关键。在这个项目中，我们打算建立一个专家系统诊断CMD，根据数据库的临床体征/症状和因素的CMD患者。我们设计了一个CMD数据库，输入了大约400例患者的数据。为了量化CMD的临床特征，使用该系统。结果表明，开放性疼痛与开放受限之间存在着密切的关系，开放性疼痛与开放受限之间存在着一定的规律性。此外，还认识到临床特征因因素而异。也就是说，在有情绪压力的患者中，主要症状不太普遍，相关症状明显普遍。垂直距离低、颞下颌关节区、枕肌触痛及伴随症状者， ...更多信息 报复开牙合患者颞下颌关节疼痛发生率最高，咬肌触诊疼痛发生率最低。咬合干扰、颞下颌关节噪音和二腹肌后触痛的患者明显多于开放受限的患者。这些患者的咬合接触模式表现为左右牙弓之间的接触点较小且分布不均匀。临床症状、体征的单侧识别率和咬合干扰的同侧识别率均具有显著性差异。特别是在引导下颌运动的后牙咬合面和中、外侧位置上检测到的咬合干扰最多，这表明利用数据库和专家系统对CMD进行鉴别诊断和病因诊断是可行的。因此，我们打算揭示CMD的内在特性，并改进这一系统。少

To lead the successful outcome of the treatment in craniomandibular disorders, it is essential to establish proper differential and etiological diagnosis. In this project we intend to construct an expert system for diagnosis in CMD, based on a database regarding the clinical signs/symptoms and the factors of CMD patients. We designed a database for CMD and the data of about 400 patients were entered. In order to quantify the clinical characteristics of CMD using this system. As the result, it was recognized that a prevalence pattern of symptoms have a regularity, for example, there were a strong relationships between opening pain and limited opening. Also, it was recognized that the clinical characteristics differ with the factors. That is, in patients with emotional stress, major symptom was less prevalent and associated symptom was significantly prevalent. Patients with low vertical dimension, palpation pain on TMJ region, occipital muscles and associated symptom were significantly p … More revalent. Patients with Open-bite, pain on TMJ region was significantly prevalent and palpation pain on masseter muscle was less prevalent. Patients with occlusal interference, TMJ noise and palpation pain of posterior digastric muscle were significantly prevalent while limited opening was less prevalent. The occlusal contact pattern of these patients had shown small contact points and uneven distribution between right and left arches. Furthermore, the rate of clinical signs and symptoms were recognized on the unilateral and that of occlusal interferences were observed in the same side were significant. Especially, most occlusal interferences were detected on the occlusal facets of the posterior teeth that guides mandibular movement to protrude and mediolateral position.These results indicate that a differential as well as etiological diagnosis for CMD are feasible by the use of database and expert system. We therefore intend to reveal inherent characteristics of CMD, and to improve this system. Less