DEVELOPMENT OF EXPERT SYSTEM FOR DIFFERENTIAL DIAGNOSIS AND ETIOLOGICAL DIAGNOSIS IN TEMPOROMANDIBULAR DISORDERS.

本研究的目的是开发用于颞颌关节紊乱病鉴别诊断和病因学诊断的专家系统。对TMD患者的临床体征和症状的患病率、体征和症状的符合率及相关程度进行统计分析，为建立有效的诊断流程和可靠的诊断标准选择充分的诊断因素。采用压敏片“牙体预刻度”对正常人和TMD患者牙弓上的咬合力分布进行分析，找出TMD患者临床症状和体征发生的特点。提示TMD在临床条件下所特有的这些明确的模式可作为鉴别TMD与其他疾病的诊断标准。正常人牙弓上的咬合力在左右牙弓之间呈对称分布。而在TMD患者中，TMD患者的TMD与正常对照组之间存在差异。根据这一发现，咬合力分布的对称性可能是TMD发病的贡献因素之一，并可在病因诊断中作为咬合因素的指标。基于这些结果，TMD专家诊断系统的开发目前正在进行中。

The aim of this research project was to develop expert systems fot the differential diagnosis and etiological diagnosis in temporomandibular disorders (TMDs). In order to select the sufficient diagnostic factors for establishing the efficient diagnostic process and reliable criteria, the prevalence rates of clinical signs and symptoms, the coincidence rates and the strength of correlation among the signs and symptoms in TMD patients, were evaluated statistically. Furthermore, the bite force distribution on the dental arches in the normal subjects and TMD patients were analyzed by using pressure-sensitive foil "Dental Prescale".As the results, the characteristic patterns in occurrence of the clinical signs and symptoms were detected in TMD patients. It is suggested that these definite patterns peculiar to TMDs in clinical conditions could be utilised as the diagnostic criteria for differentiating TMD from others. The bite force distribution on the dental arches were symmetrical between the right and left arches in the normal subjects. On the other hand, those in the TMD patients were deviated from those in the normal subjects. According to this finding, the symmetry of bite force distribution would be the one of the contributions factors to the onset of TMD,and could be utilized as an indicator of occlusal factors in the etiological diagnosis.Based on these results, the project of developing the expert diagnostic systems for TMD are progressed at present.