Variability of disk position in asymptomatic volunteers and patients with internal derangements of the TMJ
Variability of disk position in asymptomatic volunteers and patients with internal derangements of the TMJ
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DOI：
10.1016/s1079-2104(97)90248-1
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发表时间：
1997-03-01
影响因子：
--
通讯作者：
Gernet, W
中科院分区：
文献类型：
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作者：
Rammelsberg, P;Pospiech, PR;Gernet, W
本研究采用磁共振成像（MRI）技术，对颞下颌关节盘在关节内侧、中央和外侧的位置进行了研究。受试者有颞下颌关节相互咔嗒声（N = 123）或下颌运动受限（N = 52）的临床证据。89名无症状志愿者作为对照组。通过测量一条穿过髁中间并垂直于法兰克福平面的线与一条穿过髁同一中点并与椎间盘最后面相切的线形成的角度，在MRI上量化椎间盘位置。在无症状的颞下颌关节盘的位置变化很大，倾向于更远的前放置在更多的侧位图像。在总共52个TMJ中的47个TMJ（90%）中，活动受限与未复位的前盘移位（ADD）相关。关节盘位置显示平均移位77 °，髁突内侧和外侧无显著差异。共有123个TMJ（81%）出现往复咔哒声，其中100个TMJ显示ADD伴复位。断层扫描显示更大的横向位移或旋转位移，在这些关节，而内侧图像经常显示类似的范围内的磁盘位置相比，无症状的颞下颌关节。结果表明，内侧断层片上高达+15度的椎间盘位置和外侧断层片上高达+30度的椎间盘位置应被视为正常变化。此外，对所有关节旁图像的多切片分析改善了关节盘移位和无症状TMJ之间的分离。
This study determined the variability of temporomandibular joint (TMJ) disk position in medial, central, and lateral aspects of the joint using magnetic resonance imaging (MRI). Subjects had clinical evidence of reciprocal TMJ clicking (N = 123) or restricted mandibular motion (N = 52). Eighty-nine asymptomatic volunteers provided a control group. Disk position was quantified on MRI by measuring the angle formed by a line through the middle of the condyle and perpendicular to the Frankfort plane and a line through the same midpoint of the condyle and tangential to the posterior-most aspect of the disk. The disk position in asymptomatic TMJs varied considerably with a tendency toward farther anterior placement in more lateral images. In 47 TMJs from a total of 52 TMJs (90%), restricted mobility was associated with anterior disk displacement (ADD) without reduction. The disk position demonstrated a mean displacement of 77 degrees without significant differences at the medial and lateral aspects of the condyle, One hundred TMJs from a total of 123 TMJs (81%) with reciprocal clicking demonstrated ADD with reduction. Tomograms revealed larger lateral displacements or rotational displacements in these joints, whereas medial images frequently showed similar ranges of disk positions as compared with asymptomatic TMJs. The results suggest that disk positions of up to +15 degrees on medial tomograms and +30 degrees on lateral tomograms should be regarded as normal variations. Furthermore, multisection analysis of all parasagittal images improved the separation between disk displacement and asymptomatic TMJs.