顎変形症患者の顎関節症状と顎顔面形態との関連

• Published in: 日本口腔外科学会雑誌 Vol. 57; no. 8; pp. 441 - 451
• Main Authors: 相川, 弦, 小林, 正治, 齋藤, 功, 林, 孝文, 齊藤, 力
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.08.2011
• Subjects: 顎変形症; 顎関節症状; 顎顔面形態
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.57.441

The purpose of this study was to determine the incidence of temporomandibular joint （TMJ） symptoms in patients with jaw deformities and to assess the relationship between TMJ symptoms and craniofacial morphology. In 304 patients with jaw deformities （221 females and 83 males, mean age: 21 y）, the TMJ was examined clinically and by axial computed tomography （CT）. Craniofacial morphology was analyzed on posteroanterior and lateral cephalograms, and the subjects were divided into seven groups: mandibular prognathism （210）, mandibular retrusion （51）, mandibular asymmetry （16）, maxillary retrusion （13）, maxillary protrusion （8）, maxillary and mandibular protrusion （4）, and open bite （2）. The incidence of disc displacement in females （32.6％） was significantly higher than that in males （19.6％）. The incidence of clinical symptoms in patients with mandibular asymmetry was 62.5％, which was significantly higher than the incidences in patients with mandibular prognathism （24.8％） and patients with maxillary retrusion （23.1％）. The incidence of disc displacement in patients with mandibular retrusion was 66.7 ％, which was significantly higher than the incidences in patients with mandibular prognathism （17.1 ％） and patients with maxillary retrusion （23.1％）. The incidences of bone changes of the condylar head in patients with mandibular retrusion, mandibular asymmetry, and maxillary retrusion were 47.1％, 43.8％, and 30.8％, respectively, which were significantly higher than the incidence in patients with mandibular prognathism （10.5％）. The incidences of disc displacement and bony changes of the condylar head in patients with asymmetry were significantly higher than those in patients without asymmetry. Disc displacement and bony changes of the condylar head were associated with mandibular retrusion, clockwise rotation of the mandible, and lateral shift of the mandible. We conclude that disc displacements and bone changes of the condyle are associated with mandibular retrusion and mandibular asymmetry.