A study for deciding the anterior guidance of TMD patients.

当我们处理TMD患者时，我们有一些病例必须重建他们的咬合。在这种情况下，我们有时指的是患者佩戴的稳定夹板的咬合。但由于对这种治疗方法没有明确的指导，我们不得不反复尝试。本研究的目的就是对这种治疗方法进行指导。研究对象为曾在东京医科大学口腔修复科接受治疗的三名TMD患者。通过改变患者使用自固化树脂固定夹板的前向引导，观察患者所佩戴的夹板束束的变化。结果发现，如果用树脂改变稳定夹板的前向引导，随着时间的推移，这种引导往往会磨损。这一事实表明，使用树脂夹板很难改变患者对夹板的前导，但对于其他材料，如不易磨损的金属，还需要进一步研究才能改变指导。我们还分析了患者在使用夹板和不使用夹板的侧移过程中的髁突运动，以观察夹板对患者髁状突运动的影响，从而改变了夹板和不夹板对髁状突运动的汇聚性，因此，在重建患者的咬合时，可以参考稳定夹板和稳定夹板的汇聚。

When we deal with TMD patients, we have some cases which we must reconstruct their occlusion. In such cases, we sometimes refer to the occlusion of the stabilization splint worn by the patients. But as we have no definite guide for this kind of treatments, we have to treat them through try and error.The purpose of this study is to make a guide for this kind of treatment. Three TMD patients were joined as subjects who had been treated in the prosthodontic section of Tokyo Medical and Dental University. Changing their anterior guidance of their stabilization splint with self-curing resin, we observed the change of fascets of the splints worn by the patients.As a result, we revealed the fact that if we change the anterior guidance of the splint with resin, such guidance tend to be worn out as the time passed. This fact indicates that it is difficult to change their anterior guidance of the splint with resin.But further study is needed for other materials like metal which is not worn out easily to change the guidances.And we analyze the condylar movements of the patients during lateral excursions with and without splint to see the effects of the splint.As a result, the convergence of the condylar movements were changed with and without splint, so we may refer to the convergence of the condylar movements with stabilization splint in reconstructing the occlusion of the patients.