Tenderness at first visit in cases of temporomandibular joint disorders
This study was designed to evaluate tenderness in patients who were examined for tempormandibular joint (TMJ) disorders, as a part of team approach to the treatment of TMJ disorders at Tsurumi University. One hundred twenty patients were examined between June 1991 and February 1995. Sixty-seven (55....
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| Published in | Journal of the Japanese Society for the Temporomandibular Joint Vol. 8; no. 3; pp. 575 - 585 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English Japanese |
| Published |
The Japanese Society for Temporomandibular Joint
1996
一般社団法人 日本顎関節学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0915-3004 1884-4308 |
| DOI | 10.11246/gakukansetsu1989.8.575 |
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| Abstract | This study was designed to evaluate tenderness in patients who were examined for tempormandibular joint (TMJ) disorders, as a part of team approach to the treatment of TMJ disorders at Tsurumi University. One hundred twenty patients were examined between June 1991 and February 1995. Sixty-seven (55.8%) of these patients (10 males, 57 females, mean age 41±18 years) had tenderness. The tenderness was assessed at 14 sites. It was on the ipsilateral side more often than on the contralateral side, and many patients had it in two sites. According to the classification of TMJ disorders in the Japanese Society for TMJ, tenderness was most frequently noted in the following sites: class I-posterior aspect of the ramus including the digastric muscle, shallow part of the masseter muscle, anterior temporal muscle, and sternocleidomastoid muscle; class II-condyle area; class III (anterior disk displacement with reduction) -posterior a spect of the ramus including the digastric muscle, shallow part of the masseter muscle, and anterior temporal muscle; class III (anterior disk displacement without reduction) -condyle area and shallow part of masseter muscle; class IV-posterior aspect of the ramus including the digastric muscle, shallow part of the masseter muscle, and anterior temporal muscle. The results of this study indicated that although there was no clear-cut relationship between the Japanese classification of TMJ disorders and the sites of tenderness, there were specific sites of tenderness associated with the TMJ disorders. |
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| AbstractList | This study was designed to evaluate tenderness in patients who were examined for tempormandibular joint (TMJ) disorders, as a part of team approach to the treatment of TMJ disorders at Tsurumi University. One hundred twenty patients were examined between June 1991 and February 1995. Sixty-seven (55.8%) of these patients (10 males, 57 females, mean age 41±18 years) had tenderness. The tenderness was assessed at 14 sites. It was on the ipsilateral side more often than on the contralateral side, and many patients had it in two sites. According to the classification of TMJ disorders in the Japanese Society for TMJ, tenderness was most frequently noted in the following sites: class I-posterior aspect of the ramus including the digastric muscle, shallow part of the masseter muscle, anterior temporal muscle, and sternocleidomastoid muscle; class II-condyle area; class III (anterior disk displacement with reduction) -posterior a spect of the ramus including the digastric muscle, shallow part of the masseter muscle, and anterior temporal muscle; class III (anterior disk displacement without reduction) -condyle area and shallow part of masseter muscle; class IV-posterior aspect of the ramus including the digastric muscle, shallow part of the masseter muscle, and anterior temporal muscle.The results of this study indicated that although there was no clear-cut relationship between the Japanese classification of TMJ disorders and the sites of tenderness, there were specific sites of tenderness associated with the TMJ disorders.
本研究は鶴見大学附属病院の臨床各科が集まって行っている顎関節症診断会の症例の中で, 初診時に圧痛を有した症例について検討を行った。本会で診断を受けた症例数は1995年2月までに120例であった。圧痛を有した症例は67例 (55.8%), 年齢: 41±18歳, 男性: 10例, 女性: 57例であった。圧痛部位は14箇所に定めて手指により圧迫した。疾患側は右側が24例 (35.8%), 両側が22例 (32.8%), 左側が21例 (31.4%) であった。圧痛は罹患側に多く発現し, 2箇所に圧痛部位を有した症例が最も多かった。圧痛部位と顎関節学会の症型分類との関係ではI型は顎二腹筋を含む下顎枝後部, 咬筋浅部, 側頭筋前部, 胸鎖乳突筋に, II型は下顎頭後方部に, III型復位を伴う場合は顎二腹筋を含む下顎枝後部, 咬筋浅部, 側頭筋前部, 胸鎖乳突筋に, III型復位を伴わない場合は下顎頭後方部, 咬筋浅部に, IV型は顎二腹筋を含む下顎枝後部, 咬筋浅部, 側頭筋前部の部分が多くの症例で圧痛を有した。今回の結果から症型分類と圧痛部位とは明瞭な関係はなかったものの, 圧痛の出現部位に一つの傾向が認められた。 This study was designed to evaluate tenderness in patients who were examined for tempormandibular joint (TMJ) disorders, as a part of team approach to the treatment of TMJ disorders at Tsurumi University. One hundred twenty patients were examined between June 1991 and February 1995. Sixty-seven (55.8%) of these patients (10 males, 57 females, mean age 41±18 years) had tenderness. The tenderness was assessed at 14 sites. It was on the ipsilateral side more often than on the contralateral side, and many patients had it in two sites. According to the classification of TMJ disorders in the Japanese Society for TMJ, tenderness was most frequently noted in the following sites: class I-posterior aspect of the ramus including the digastric muscle, shallow part of the masseter muscle, anterior temporal muscle, and sternocleidomastoid muscle; class II-condyle area; class III (anterior disk displacement with reduction) -posterior a spect of the ramus including the digastric muscle, shallow part of the masseter muscle, and anterior temporal muscle; class III (anterior disk displacement without reduction) -condyle area and shallow part of masseter muscle; class IV-posterior aspect of the ramus including the digastric muscle, shallow part of the masseter muscle, and anterior temporal muscle. The results of this study indicated that although there was no clear-cut relationship between the Japanese classification of TMJ disorders and the sites of tenderness, there were specific sites of tenderness associated with the TMJ disorders. |
| Author | TOYODA, Nagataka BEPPU, Satoshi TAKAYAMA, Yasuko KOBAYASHI, Kaoru FUKUSHIMA, Shunji KAMEI, Shu OGAWA, Takumi ARAKI, Jiro HOSODA, Yutaka YAMANAKA, Satoshi SUZUKI, Satoshi OZAWA, Toshiko ITOH, Kousuke MORITA, Takeshi SEKIYA, Hideki SHIINA, Nobuaki |
| Author_FL | 関谷 秀樹 伊藤 孝介 森田 武 亀井 秀 椎名 順朗 別部 智司 鈴木 聡 豊田 長隆 小澤 寿子 小林 馨 細田 裕 高山 慈子 小川 匠 山中 悟史 荒木 次朗 福島 俊士 |
| Author_FL_xml | – sequence: 1 fullname: 別部 智司 – sequence: 2 fullname: 小林 馨 – sequence: 3 fullname: 森田 武 – sequence: 4 fullname: 関谷 秀樹 – sequence: 5 fullname: 小川 匠 – sequence: 6 fullname: 荒木 次朗 – sequence: 7 fullname: 亀井 秀 – sequence: 8 fullname: 伊藤 孝介 – sequence: 9 fullname: 細田 裕 – sequence: 10 fullname: 山中 悟史 – sequence: 11 fullname: 鈴木 聡 – sequence: 12 fullname: 豊田 長隆 – sequence: 13 fullname: 高山 慈子 – sequence: 14 fullname: 小澤 寿子 – sequence: 15 fullname: 椎名 順朗 – sequence: 16 fullname: 福島 俊士 |
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| References | 19) 波多野泰夫, 田外貴弘, 他: 顎関節症評価のための圧痛検査部位の検索 (抄), 日顎誌 6: 207-208, 1994. 15) 吉浦彰謙, 波多野泰夫, 他: 顎関節疾患者のスプリント治療に伴う圧痛の変化, 歯学 80: 28-50, 1992. 21) 岸本和子, 木村公一, 他: 咀嚼筋と茎状突起部の圧痛閾値の関連について -健常者と顎機能異常者の経日変動- (抄), 日本顎関節学会総会プログラム・予稿抄録集: 206, 1995. 16) 窪田 豊, 波多野泰夫, 他: 顎関節疾患者のスプリント治療による臨床症状の経時的推移, 歯学 80: 731-754, 1992. 18) 波多野泰夫, 丸茂義二, 他: 顎関節症の臨床 (8) 圧痛検査の実際 (抄), 補綴誌 37, 89th Special Issue: 127, 1993. 2) 伊藤孝介, 小川 匠, 他: 顎関節症へのチームアプローチ 第1報 TMJ診療録について (抄), 鶴見歯学 20: 392, 1994. 20) 酒井利行, 田外貴弘, 他: 顎関節症治療に伴う圧痛の左右差の変化について (抄), 日顎誌 7: 280, 1995. 4) 杉崎正志, 伊介昭弘, 他: 顎関節症における加圧疼痛閾値の臨床評価 第1報: 加圧疼痛計の試作と自覚的無症状者における評価, 日顎誌 5: 37-47, 1993. 12) 小林義典: 咀嚼系機能障害 -補綴臨床の立場から-, 日本歯科評論 412: 35-50, 1977. 24) Libman, E.: Observation on individual sensitiveness to pain, J Amer Med Ass 102: 335-341, 1935. 23) 木下晴都: 臨床経穴図, 第19版, 医道の日本社, 東京, 1991. 8) Chung, S. C., Kim, J. H., et al: Reliability and validity of the pressure pain thresholds (PPT) in the TMJ capsules by electronic algometer, J Craniomandibular Practice 11: 171-176, 1993. 1) 小野尊睦: 顎関節症分類案. 顎関節症研究会誌 7: 巻末, 1987. 13) 波多野泰夫, 窪田 豊, 他: 顎機能異常の診査と治療効果判定における圧痛検査の意義, 補綴臨床 22: 793-800, 1989. 10) Kawakita K., Miura, T., et al: Deep pain measurement at tender points by pulse algometry with insulated needle electrodes, Pain 44: 235-239, 1991. 6) 杉崎正志, 伊介昭弘, 他: 顎関節症における加圧疼痛閾値の臨床評価 第3報: 女性有痛者のカットオフ値の検討, 日顎誌 6: 62-69, 1994. 9) Fischer, A. A.: Pressure algometry over normal muscles. Standard values, validity and reproductivity of pressure threshold, Pain 30: 115-126, 1987. 11) Fricton, J., and Schiffman, E. L.: Reliability of craniomandibular index. J Dent Res 65: 1359-1364, 1986. 7) 大山良樹, 佐々木和郎, 他: 新しく開発した圧痛計による加圧面積の検討, 日本東洋医学雑誌 45: 945-951, 1995. 22) 藍 稔: 筋の機能障害に由来する顔面・頭部の痛み. 東京医科歯科大学歯学部顎口腔総合研究施設編; 顎運動とそのメカニズム, 第3版, 日本歯科評論社, 東京, 1981, 430-438頁. 17) 三井靖徳, 波多野泰夫, 他: 顎関節症検査のための圧痛検査部位に関する研究, 歯学 81: 681-704, 1993. 14) 石崎一成, 波多野泰夫, 他: 顎関節疾患者における圧痛, 歯学 79: 1267-1287, 1992. 3) Friedman, M. H., Weisberg, J.: Pitfalls of muscle palpation in TMJ diagnosis. J Prosthet Dent 48: 331, 1982. 5) 杉崎正志, 伊介昭弘, 他: 顎関節症における加圧疼痛閾値の臨床評価 第2報: 女性における個人の加圧疼痛感受性について, 日顎誌 5: 374-380, 1993. |
| References_xml | – reference: 19) 波多野泰夫, 田外貴弘, 他: 顎関節症評価のための圧痛検査部位の検索 (抄), 日顎誌 6: 207-208, 1994. – reference: 11) Fricton, J., and Schiffman, E. L.: Reliability of craniomandibular index. J Dent Res 65: 1359-1364, 1986. – reference: 4) 杉崎正志, 伊介昭弘, 他: 顎関節症における加圧疼痛閾値の臨床評価 第1報: 加圧疼痛計の試作と自覚的無症状者における評価, 日顎誌 5: 37-47, 1993. – reference: 1) 小野尊睦: 顎関節症分類案. 顎関節症研究会誌 7: 巻末, 1987. – reference: 8) Chung, S. C., Kim, J. H., et al: Reliability and validity of the pressure pain thresholds (PPT) in the TMJ capsules by electronic algometer, J Craniomandibular Practice 11: 171-176, 1993. – reference: 18) 波多野泰夫, 丸茂義二, 他: 顎関節症の臨床 (8) 圧痛検査の実際 (抄), 補綴誌 37, 89th Special Issue: 127, 1993. – reference: 12) 小林義典: 咀嚼系機能障害 -補綴臨床の立場から-, 日本歯科評論 412: 35-50, 1977. – reference: 23) 木下晴都: 臨床経穴図, 第19版, 医道の日本社, 東京, 1991. – reference: 3) Friedman, M. H., Weisberg, J.: Pitfalls of muscle palpation in TMJ diagnosis. J Prosthet Dent 48: 331, 1982. – reference: 22) 藍 稔: 筋の機能障害に由来する顔面・頭部の痛み. 東京医科歯科大学歯学部顎口腔総合研究施設編; 顎運動とそのメカニズム, 第3版, 日本歯科評論社, 東京, 1981, 430-438頁. – reference: 13) 波多野泰夫, 窪田 豊, 他: 顎機能異常の診査と治療効果判定における圧痛検査の意義, 補綴臨床 22: 793-800, 1989. – reference: 2) 伊藤孝介, 小川 匠, 他: 顎関節症へのチームアプローチ 第1報 TMJ診療録について (抄), 鶴見歯学 20: 392, 1994. – reference: 14) 石崎一成, 波多野泰夫, 他: 顎関節疾患者における圧痛, 歯学 79: 1267-1287, 1992. – reference: 17) 三井靖徳, 波多野泰夫, 他: 顎関節症検査のための圧痛検査部位に関する研究, 歯学 81: 681-704, 1993. – reference: 24) Libman, E.: Observation on individual sensitiveness to pain, J Amer Med Ass 102: 335-341, 1935. – reference: 9) Fischer, A. A.: Pressure algometry over normal muscles. Standard values, validity and reproductivity of pressure threshold, Pain 30: 115-126, 1987. – reference: 15) 吉浦彰謙, 波多野泰夫, 他: 顎関節疾患者のスプリント治療に伴う圧痛の変化, 歯学 80: 28-50, 1992. – reference: 21) 岸本和子, 木村公一, 他: 咀嚼筋と茎状突起部の圧痛閾値の関連について -健常者と顎機能異常者の経日変動- (抄), 日本顎関節学会総会プログラム・予稿抄録集: 206, 1995. – reference: 6) 杉崎正志, 伊介昭弘, 他: 顎関節症における加圧疼痛閾値の臨床評価 第3報: 女性有痛者のカットオフ値の検討, 日顎誌 6: 62-69, 1994. – reference: 16) 窪田 豊, 波多野泰夫, 他: 顎関節疾患者のスプリント治療による臨床症状の経時的推移, 歯学 80: 731-754, 1992. – reference: 20) 酒井利行, 田外貴弘, 他: 顎関節症治療に伴う圧痛の左右差の変化について (抄), 日顎誌 7: 280, 1995. – reference: 10) Kawakita K., Miura, T., et al: Deep pain measurement at tender points by pulse algometry with insulated needle electrodes, Pain 44: 235-239, 1991. – reference: 5) 杉崎正志, 伊介昭弘, 他: 顎関節症における加圧疼痛閾値の臨床評価 第2報: 女性における個人の加圧疼痛感受性について, 日顎誌 5: 374-380, 1993. – reference: 7) 大山良樹, 佐々木和郎, 他: 新しく開発した圧痛計による加圧面積の検討, 日本東洋医学雑誌 45: 945-951, 1995. |
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| Title | Tenderness at first visit in cases of temporomandibular joint disorders |
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