Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Skeletal Factors Related to Open Lock of the Temporomandibular Joint

측두하악관절의 개구성 과두걸림 환자의 골격적 특성에 관한 연구

  • Nam, Ji-Na (Dept. of Oral Medicine and Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University) ;
  • Lee, Jeong-Yun (Dept. of Oral Medicine and Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University)
  • 남지나 (서울대학교 치과대학 구강내과학교실) ;
  • 이정윤 (서울대학교 치과대학 구강내과학교실)
  • Received : 2013.06.10
  • Accepted : 2013.08.05
  • Published : 2013.09.30
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Abstract

This study was performed to investigate the skeletal factors related to open lock of the temporomandibular joint(TMJ). We compared the skeletal measurements on the cephalogram and transcranial radiograph among 3 groups, open lock group consisting of consecutively filed 50 patients with at least one open lock episode within recent 1 year, temporomandibular disorder(TMD) group of 50 TMD patients without open lock diagnosed by Research Diagnostic Criteria for TMD (RDC/TMD) Axis I, and normal group of 50 patients without TMD or open lock. The patients of TMD and normal group were randomly selected in an age-and-gender-matched way with ones of open lock group. Open lock group showed smaller saddle angle than normal group on cephalograms and steeper inclination of the articular eminence than TMD and normal groups on transcranial radiographs. These results imply that the patients with the joint located more anterior and the articular eminence with steeper inclination might be riskier to TMJ open lock.

본 연구는 측두하악관절의 개구성 과두걸림과 골격적 특성 사이의 연관성을 분석하고자 개구성 과두걸림 환자를 대상으로 측두두부방사선 사진과 횡두개촬영 방사선 사진을 이용하여 두개골의 골격적 특성 및 관절 융기의 기울기를 비교 분석하였다. 개구성 과두걸림 환자를 환자군으로 하고 개구성 과두걸림은 없지만 측두하악장애 연구진단 기준(Research Diagnostic Criteria for Temporomandibular Disorder; RDC/TMD) Axis I에 따라 측두하악장애으로 진단된 환자를 측두하악장애 환자군, 개구성 과두걸림과 측두하악장애가 모두 없는 정상 환자를 정상군으로 설정하고 순차적으로 수집된 환자군 50명과 성별 및 연령이 일치하도록 무작위로 측두하악장애 환자군과 정상군, 각각 50명의 임상기록을 선별하였다. 측두하악장애에 영향을 줄 수 있는 관절염이나 외상의 병력, 악안면 기형, 악안면 수술 병력이 있는 환자는 모두 제외하였다. 세 군의 측두두부규격방사선 사진과 횡두개촬영 방사선 사진을 분석하여 골격적 특성과 관절 융기의 기울기를 측정하였다. 두개골과 하악과의 골격적 특성을 나타내는 측두두부방사선 사진을 분석한 결과 개구성 과두걸림이 있는 환자군에서 하악의 전후방적 위치를 나타내어주는 saddle angle이 더 작은 것으로 나타났으며 이는 두개골에 대해 하악이 더 전방으로 위치하고 있음을 나타낸다. 또한 횡두개촬영 방사선 사진상에서는 개구성 과두걸림 환자군이 측두하악장애 환자군과 정상군보다 관절융기의 기울기가 더 크게 관찰되었다. 이러한 결과는 두개골에 대해 측두하악관절이 더 전방으로 위치하고 관절 융기가 더 급한 경사를 가질 경우 개구성 과두걸림이 발생할 가능성이 더 크다는 것을 의미한다.

Keywords

References

  1. Bagis B, Ayaz EA, Turgut S, Durkan R, Ozcan M. Gender difference in prevalence of signs and symptoms of temporomandibular joint disorders: a retrospective study on 243 consecutive patients. Int J Med Sci 2012;9:539-544. https://doi.org/10.7150/ijms.4474
  2. Gomes NC, Berni-Schwarzenbeck KC, Packer AC, Rdrigues-Bigaton D. Effect of cathodal high-voltage electrical stimulation on pain in women with TMD. Rev Bras Fisioter 2012;16:10-15. https://doi.org/10.1590/S1413-35552012000100003
  3. Costa AL, Campos LS, Franca Jr MC, D'Abreu A. Temporomandibular disorders in patients with craniocervical dystonia. Arq Neuropsiquiatr 2011;69: 896-899. https://doi.org/10.1590/S0004-282X2011000700009
  4. Sindet-Pedersen S. Intraoral myotomy of the lateral pterygoid muscle for treatment of recurrent dislocation of the mandibular condyle. J Oral Maxillofac Surg 1988;46:445-449. https://doi.org/10.1016/0278-2391(88)90409-0
  5. Akinbami BO. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation. Head Face Med 2011;7:10. https://doi.org/10.1186/1746-160X-7-10
  6. Ugboko VI, Oginni FO, Ajike SO, Olasoji HO, Adebayo ET. A survey of temporomandibular joint dislocation: aetiology, demographics, risk factors and management in 96 Nigerian cases. Int J Oral Maxillofac Surg 2005;34:499-502. https://doi.org/10.1016/j.ijom.2004.10.025
  7. Vasconcelos BC, Porto GG, Neto JP, Vasconcelos CF. Treatment of chronic mandibular dislocations by eminectomy: follow-up of 10 cases and literature review. Med Oral Patol Oral Cir Bucal 2009;14: e593-596.
  8. Preti G, Bruscagin C, Scotti R, Cardesi E. Statistical study of the angle formed by the lateral part of the mandibular condyle and the horizontal plane. J Prosthet Dent 1983;50:571-575. https://doi.org/10.1016/0022-3913(83)90583-8
  9. Luyk NH, Larsen PE. The diagnosis and treatment of the dislocated mandible. Am J Emerg Med 1989;7: 329-335.
  10. Katsavrias EG. Changes in articular eminence inclination during the craniofacial growth period. Angle Orthod 2002;72:258-264.
  11. Torres DE, McCain JP. Arthroscopic electrothermal capsulorrhaphy for the treatment of recurrent temporomandibular joint dislocation. Int J Oral Maxillofac Surg 2012;41:681-689. https://doi.org/10.1016/j.ijom.2012.03.008
  12. Baur DA, Jannuzzi JR, Mercan U, Quereshy FA. Treatment of long term anterior dislocation of the TMJ. Int J Oral Maxillofac Surg 2013.
  13. Mayrink G, Olate S, Assis A, Sverzut A, de Moraes M. Recurrent mandibular dislocation treated by eminectomy. J Craniofac Surg 2012;23:e516-520. https://doi.org/10.1097/SCS.0b013e31825ab523
  14. Nitzan DW. Temporomandibular joint "open lock" versus condylar dislocation: signs and symptoms, imaging, treatment, and pathogenesis. J Oral Maxillofac Surg 2002;60:506-511; discussion 512-503. https://doi.org/10.1053/joms.2002.31846
  15. Kai S, Kai H, Nakayama E, et al. Clinical symptoms of open lock position of the condyle. Relation to anterior dislocation of the temporomandibular joint. Oral Surg Oral Med Oral Pathol 1992;74:143-148. https://doi.org/10.1016/0030-4220(92)90372-W
  16. Taglialatela Scafati C, Taglialatela Scafati S. Role of orthognathic surgery in the treatment of recurrent mandibular dislocation: importance of mandibular ramus inclination. J Craniofac Surg 2012;23:e420-423. https://doi.org/10.1097/SCS.0b013e31825e3ca2
  17. Fukui T, Tsuruta M, Murata K, et al. Correlation between facial morphology, mouth opening ability, and condylar movement during opening-closing jaw movements in female adults with normal occlusion. Eur J Orthod 2002;24:327-336. https://doi.org/10.1093/ejo/24.4.327
  18. Tuijt M, Koolstra JH, Lobbezoo F, Naeije M. Biomechanical modeling of open locks of the human temporomandibular joint. Clin Biomech (Bristol, Avon) 2012;27:749-753. https://doi.org/10.1016/j.clinbiomech.2012.04.007
  19. Jarvinen S. Saddle angle and maxillary prognathism: a radiological analysis of the association between the NSAr and SNA angles. Br J Orthod 1984;11:209-213. https://doi.org/10.1179/bjo.11.4.209
  20. Mestriner Junior W, Valente A. [Facial prognathism and its relation to the cranial base in Brazilian children with Class I malocclusion]. Rev Odontol Univ Sao Paulo 1989;3:324-333.
  21. Van Sickels JE, Bianco HJ, Jr., Pifer RG. Transcranial radiographs in the evaluation of craniomandibular (TMJ) disorders. J Prosthet Dent 1983;49:244-249. https://doi.org/10.1016/0022-3913(83)90510-3
  22. Keesler JT, Christensen LV, Donegan SJ, Austin BP. A transcranial radiographic examination of the temporal portion of the temporomandibular joint. J Oral Rehabil 1992;19:71-84. https://doi.org/10.1111/j.1365-2842.1992.tb01592.x
  23. Undt G. Temporomandibular joint eminectomy for recurrent dislocation. Atlas Oral Maxillofac Surg Clin North Am 2011;19:189-206. https://doi.org/10.1016/j.cxom.2011.05.005
  24. Manfredini D. Etiopathogenesis of disk displacement of the temporomandibular joint: a review of the mechanisms. Indian J Dent Res 2009;20:212-221. https://doi.org/10.4103/0970-9290.51365
  25. Atkinson WB, Bates RE, Jr. The effects of the angle of the articular eminence on anterior disk displacement. J Prosthet Dent 1983;49:554-555. https://doi.org/10.1016/0022-3913(83)90321-9
  26. Hall MB, Gibbs CC, Sclar AG. Association between the prominence of the articular eminence and displaced TMJ disks. Cranio 1985;3:237-239. https://doi.org/10.1080/08869634.1985.11678105
  27. Kerstens HC, Tuinzing DB, Golding RP, Van der Kwast WA. Inclination of the temporomandibular joint eminence and anterior disc displacement. Int J Oral Maxillofac Surg 1989;18:228-232.