TMJ DISORDERS--DIAGNOSIS WITH EXAMINATION

对普通人群的流行病学研究估计了 颞下颌关节内紊乱(TMJ ID)在14%至14%之间 44%。关节体层摄影结合头影测量的研究 校正后的TMJ断层扫描已成为诊断TMJ的标准工具 这项研究的目的是确定诊断标准是否使用 来自(1)当前问题的历史的参数组合，(2) 使用临床检查和(3)断层扫描(不进行关节断层扫描) 要建立TMJ ID的存在和阶段，将有良好的百分比 这一诊断与由 TMJ关节断层摄影术。 60名连续同意的成年人被转介到卫理公会医院接受治疗 将检查常规的关节造影评估，完成 进行问卷调查，并在进行关节造影术前拍摄TMJ断层照片。这个 病史包括(1)TMJ噪音、(2)锁定、(3)限制 开场的时候。临床检查方法：(1)最大张口度， (2)最大左侧和右侧颌骨运动；(3)侧向偏斜 开启，(4)S-开启或关闭时的曲线偏差，(5)倒数 在TMJ处点击和(6)TMJ骨化。体层摄影术意志的评估 包括：1.髁突的活动范围；2.是否退变 TMJ的骨性结构发生了变化。诊断性 TMJ ID每个阶段的标准将以两种方式确定：(1)a 基于文献综述的预先指定的集合，以及(2)源自 个体参数的判别分析。假设是这样的 诊断结果之间至少有80%的符合率 用这两种方法的诊断标准和诊断 是通过TMJ关节断层扫描得出的。如果事实证明这是真的，那么 关节断层扫描，这是一个昂贵的，侵入性的和痛苦的程序， 可保留用于(1)术前筛查/治疗计划，以及(2) 为了满足医院对外科标准的要求， 说明手术是有效的。

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.