顎関節円板の非復位性前方転位を有する患者の顎顔面形態

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  • Craniofacial morphology in patients with anterior displacement of the temporomandibular joint disk without reduction

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Accurate diagnosis of temporomandibular disorders has become available by recent advances of magnetic resonance imaging and arthroscopic examinations. The present study was conducted to investigate craniofacial morphology in patients with internal derangement of the TMJ.<br>Subjects were selected from orthodontic patients with signs and symptoms of the TMJ who underwent MRI examination (GE-Signa 1.5 Tesla) before orthodontic treatment from August 1991 to November 1993. Thirty-four patients with internal derangement of stages III, IV and/or V, classified by Wilkes criteria, were used as subjects. The subjects consisted of 27 females and 7 males ranging in age from 12 to 42 years (an average age of 20.6 years). The subjects were divided into 2 groups: unilateral (right or left, 23 subjects) and bilateral (11 subjects). The amount of lateral shift of the Me point was measured in the unilateral group by use of posteroanterior (P-A) cephalogram. For the bilateral group, the mandibular plane angle to SN, ramus height and mandibular body length were analyzed on lateral cephalograms and compared with Japanese standards.<br>In the unilateral group, 21 (91%) of the 23 patients exhibited lateral shift of the Me point to the deranged side. In the bilateral group, steep mandibular plane, short ramus height and mandibular body length were revealed in comparison with the control.<br>From these findings, it is suggested that chronic internal derangements with degenerative joint disease may be relevant to lateral shift of the mandible, steep mandibular plane, short ramus height and mandibular plane, and that these morphological characteristics may become more severe, if internal derangement of the TMJ occurs before adolescence.

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