TMJ DISORDERS--DIAGNOSIS WITH EXAMINATION

对一般人群的流行病学研究估计了 颞下颌关节内紊乱（TMJ ID）为14%至 百分之四十四 关节体层摄影检查结合头影测量 修正的颞下颌关节断层扫描已成为诊断颞下颌关节的标准工具 ID. 本研究的目的是确定诊断标准是否使用 参数的组合来自（1）当前问题的历史，（2） 临床检查和（3）断层扫描（无关节断层扫描） 为了确定TMJ ID的存在和阶段，将有良好的百分比 这一诊断和诊断之间的一致性， 颞下颌关节断层扫描。 60名连续同意的成年人被转诊到卫理公会医院， 将检查常规关节断层摄影评价，完成a 问卷调查，并在关节造影前进行TMJ断层扫描。 的 病史包括发生（1）TMJ噪音，（2）锁定，（3）限制 开放。 临床检查测量（1）最大颌骨张开度， (2)最大的左和右侧面下颌运动，（3）侧面偏差 打开，（4）打开或关闭时的S曲线偏差，（5）倒数 （6）颞下颌关节捻发音。 断层扫描评价将 有：1.髁状突的运动范围，2.是否退化 TMJ的骨质结构出现变化。 诊断 TMJ ID的每个阶段的标准将通过两种方式建立：（1）a 基于文献综述的预先规定的集合，以及（2）从 个别参数的判别分析。 前提是 诊断结果之间的最低一致率为80%， 采用这两种方法的诊断标准， 是通过颞下颌关节的断层扫描得出的 如果这是真的，那么 关节断层摄影术是一种昂贵的、侵入性的和痛苦的手术， 可保留用于（1）术前筛查/治疗计划，以及（2） 以满足医院对手术标准的要求， 手术是有效的。

Epidemiological studies on general populations estimate the prevalence of temporomandibular joint internal derangements (TMJ ID) to be between 14% to 44%. Arthrotomographic investigation in conjunction with cephalometrically corrected TMJ tomography has become a standard tool for diagnosis of TMJ ID. The purpose of this study is to determine if diagnostic criteria using a combination of parameters from (1) history of present problem, (2) clinical examination and (3) tomography (without arthrotomography) are used to establish the presence and stage of TMJ ID, there will be good percent agreement between this diagnosis and the diagnosis rendered by arthrotomography of the TMJ. Sixty sequential consenting adults referred to Methodist Hospitals for routine arthrotomographic evaluation will be examined, complete a questionnaire and have TMJ tomograms taken prior to arthrography. The history included occurrence of (1) TMJ noises, (2) locking, (3) limitation of opening. The clinical examination measures for (1) maximum jaw opening, (2) maximum left and right lateral jaw movements, (3) lateral deviation on opening, (4) S-curve deviation on opening or closing, (5) reciprocal clicking in the TMJ and (6) TMJ crepitation. Evaluation of tomography will include: 1. range of motion of the condyle, 2. whether degenerative changes are present in the osseous structures of the TMJ. Diagnostic criteria for each stage of TMJ ID will be established in two ways: (1) a prespecified set based on a literature review and (2) a set derived from discriminate analysis of individual parameters. The hypothesis is that there will be a minimum agreement of 80% between the diagnosis rendered by using the diagnostic criteria of these two methods and the diagnosis arrived at by arthrotomography of the TMJ. If this proves true, then arthrotomography, which is an expensive, invasive and painful procedure, can be reserved for (1) presurgical screening/treatment planning, and (2) to fulfill the requirements of hospitals for surgical criteria that the indicated surgery is valid.