臨床に有用な基礎知識＞顎関節症と咬合の関係に関するup-to-dateな見解
顎関節症のリスク因子には，外傷，解剖学的因子，病態生理学的因子，心理社会学的因子など多くのものがあることが知られており，そのうち単一の因子，あるいは複数の因子の複合によって発症するものと考えられる。すなわち，顎関節症の原因は患者によって異なっており，生物心理社会学的モデル（biopsychosocial model）の枠組みのなかで，病歴聴取を含む臨床的診察や検査結果を基に，目の前の患者ごとにそれらの複数のリスク因子のなかから推定されるべきである。咬合因子の顎関節症発症における役割について論じた質の高い文献は依然少ないものの，それらの文献は，咬合因子は顎関節症発症のリスク因子の一つにすぎず，咬...
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| Published in | Journal of the Japanese Society for the Temporomandibular Joint Vol. 30; no. 1; pp. 36 - 43 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本顎関節学会
20.04.2018
The Japanese Society for Temporomandibular Joint |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0915-3004 1884-4308 |
| DOI | 10.11246/gakukansetsu.30.36 |
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| Abstract | 顎関節症のリスク因子には，外傷，解剖学的因子，病態生理学的因子，心理社会学的因子など多くのものがあることが知られており，そのうち単一の因子，あるいは複数の因子の複合によって発症するものと考えられる。すなわち，顎関節症の原因は患者によって異なっており，生物心理社会学的モデル（biopsychosocial model）の枠組みのなかで，病歴聴取を含む臨床的診察や検査結果を基に，目の前の患者ごとにそれらの複数のリスク因子のなかから推定されるべきである。咬合因子の顎関節症発症における役割について論じた質の高い文献は依然少ないものの，それらの文献は，咬合因子は顎関節症発症のリスク因子の一つにすぎず，咬合が発症の最重要因子となっている症例は決して多くはないというエビデンスを一致して示している。このことは，不可逆的治療である咬合治療は顎関節症の治療法の第一選択ではなく，保存療法，可逆療法を優先すべきであるというメッセージをわれわれに伝えている。 |
|---|---|
| AbstractList | 顎関節症のリスク因子には，外傷，解剖学的因子，病態生理学的因子，心理社会学的因子など多くのものがあることが知られており，そのうち単一の因子，あるいは複数の因子の複合によって発症するものと考えられる。すなわち，顎関節症の原因は患者によって異なっており，生物心理社会学的モデル（biopsychosocial model）の枠組みのなかで，病歴聴取を含む臨床的診察や検査結果を基に，目の前の患者ごとにそれらの複数のリスク因子のなかから推定されるべきである。咬合因子の顎関節症発症における役割について論じた質の高い文献は依然少ないものの，それらの文献は，咬合因子は顎関節症発症のリスク因子の一つにすぎず，咬合が発症の最重要因子となっている症例は決して多くはないというエビデンスを一致して示している。このことは，不可逆的治療である咬合治療は顎関節症の治療法の第一選択ではなく，保存療法，可逆療法を優先すべきであるというメッセージをわれわれに伝えている。 |
| Author | 矢谷, 博文 |
| Author_xml | – sequence: 1 fullname: 矢谷, 博文 organization: 大阪大学大学院歯学研究科 顎口腔機能再建学講座 クラウンブリッジ補綴学分野 |
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| ContentType | Journal Article |
| Copyright | 2018 一般社団法人 日本顎関節学会 |
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| PublicationTitle | Journal of the Japanese Society for the Temporomandibular Joint |
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| References | 3) Moreno-Hay I, Okeson JP. Does altering the occlusal vertical dimension produce temporomandibular disorders? A literature review. J Oral Rehabil 2015; 42: 875-82. 45) Marini I, Gatto MR, Bartolucci ML, Bortolotti F, Alessandri Bonetti G, Michelotti A. Effects of experimental occlusal interference on body posture: an optoelectronic stereophotogrammetric analysis. J Oral Rehabil 2013; 40: 509-18. 11) Sato S, Goto S, Kawamura H, Motegi K. The natural course of nonreducing disc displacement of the TMJ: relationship of clinical findings at initial visit to outcome after 12 months without treatment. J Orofac Pain 1997; 11: 315-20. 52) Pullinger AG, Seligman DA. Quantification and validation of predictive values of occlusal variables in temporomandibular disorders using a multifactorial analysis. J Prosthet Dent 2000; 83: 66-75. 13) Roethlisberger J, Dickson WJ. Management and the worker. Cambridge: Harvard University Press; 1966. 35) Riise C, Sheikholeslam A. The influence of experimental interring occlusal contacts on the postural activity of the anterior temporal and masseter muscles in young adults. J Oral Rehabil 1982; 19: 419-25. 46) Xie Q, Li X, Xu X. The difficult relationship between occlusal interferences and temporomandibular disorder-insights from animal and human experimental studies. J Oral Rehabil 2013; 40: 279-95. 5) AADR TMD Policy Statement Revision Approved by AADR Council 3/3/2010. http://www.aadronline.org/i4a/pages/index.cfm?pageid=3465 7) Okeson JP. Etiology of functional disturbances in the masticatory system. In: Management of temporomandibular disorders and occlusion. 7th ed. St. Louis: Elsevier Mosby; 2013. p.102-28. 16) Mongini F. Dental abrasion as a factor in remodeling of the mandibular condyle. Acta Anat 1975; 92: 292-300. 39) 虫本栄子, 田中久敏, 遠藤義樹, 児玉厚三, 八重樫祐成, 古和田一成. 実験的咬合干渉が咬みしめ時の咀嚼筋AIに及ぼす影響. 補綴誌 1994; 38: 738-52. 27) Graf H, Zander HA. Tooth contact patterns in mastication. J Prosthet Dent 1963; 13: 1055-66. 34) 林 清平. 実験的咬合干渉が咀嚼系に与える影響. 歯学 1982; 70: 687-764. 6) The American Academy of Orofacial Pain. Diagnosis and Management of TMDs. In: de Leeuw R, Klasser GD, editors. Orofacial Pain Guidelines for Assessment, Diagnosis, and Management. 5th ed. Chicago: Quintessence Publishing; 2013. p.127-86. 21) Kampe T, Hannerz H. Five-year longitudinal study of adolescents with intact and restored dentitions: signs and symptoms of temporomandibular dysfunction and functional recordings. J Oral Rehabil 1991; 18: 387-98. 4) Manfredini D, Lombardo L, Siciliani G. Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era? J Oral Rehabil 2017; 44: 908-23. 23) Marklund S, Wänman A. Risk factors associated with incidence and persistence of signs and symptoms of temporomandibular disorders. Acta Odontol Scand 2010; 68: 289-99. 42) Michelotti A, Farella M, Steenks MH, Gallo LM, Palla S. No effect of experimental occlusal interferences on pressure pain thresholds of the masseter and temporalis muscles in healthy women. Eur J Oral Sci 2006; 114: 167-70. 8) Pullinger AG, Seligman DA, Gornbein JA. A multiple logistic regression analysis of the risk and relative odds of temporomandibular disorders as a function of common occlusal features. J Dent Res 1993; 72: 968-79. 12) Greene CS, Goddard G, Macaluso GM, Mauro G. Topical review: placebo responses and therapeutic responses. How are they related? J Orofac Pain 2009; 23: 93-107. 17) Carlsson GE, Egermark I, Magnusson T. Predictors of signs and symptoms of temporomandibular disorders: a 20-year follow-up study from childhood to adulthood. Acta Odontol Scand 2002; 60: 180-5. 51) Kirveskari P, Jämsä T, Alanen P. Occlusal adjustment and the incidence of demand for temporomandibular disorder treatment. J Prosthet Dent 1998; 79: 433-8. 31) Randow K, Carlsson K, Edlund J, Oberg T. The effect of an occlusal interference on the masticatory system. An experimental investigation. Odontol Revy 1976; 27: 245-56. 19) Magnusson T, Egermarki I, Carlsson GE. A prospective investigation over two decades on signs and symptoms of temporomandibular disorders and associated variables. A final summary. Acta Odontol Scand 2005; 63: 99-109. 30) DeBoever J. Experimental occlusal balancing-contact interference and muscle activity. Parodontologie 1969; 23: 49-56. 32) Funakoshi M, Fujita N, Takehana S. Relations between occlusal interference and jaw muscle activities in response to changes in head position. J Dent Res 1976; 55: 684-90. 53) Seligman DA, Pullinger AG. Analysis of occlusal variables, dental attrition, and age for distinguishing healthy controls from female patients with intracapsular temporomandibular disorders. J Prosthet Dent 2000; 83: 76-82. 9) Kurita K, Westesson PL, Yuasa H, Toyama M, Machida J, Ogi N. Natural course of untreated symptomatic temporomandibular joint disc displacement without reduction. J Dent Res 1998; 77: 361-5. 28) Schaerer P, Stallard RE. The effect of an occlusal interference on the tooth contact occurrence during mastication. Helv Odontol Acta 1966; 10: 49-56. 36) Magnusson T, Enbom L. Signs and symptoms of mandibular dysfunction after introduction of experimental balancing-side interferences. Acta Odontol Scand 1984; 42: 129-35. 41) Baba K, Ai M, Mizutani H, Enosawa S. Influence of experimental occlusal discrepancy on masticatory muscle activity during clenching. J Oral Rehabil 1996; 23: 55-60. 29) Schaerer P, Stallard RE, Zander HA. Occlusal interferences and mastication: an electromyographic study. J Prosthet Dent 1967; 17: 438-49. 25) Farronato G, Rosso G, Giannini L, Galbiati G, Maspero C. Correlation between skeletal Class Ⅱ and temporomandibular joint disorders: a literature review. Minerva Stomatol 2016; 65: 239-47. 47) Cioffi I, Farella M, Festa P, Martina R, Palla S, Michelotti A. Short-term sensorimotor effects of experimental occlusal interferences on the wake-time masseter muscle activity of females with masticatory muscle pain. J Oral Facial Pain Headache 2015; 29: 331-9. 40) Christensen LV, Rassouli NM. Experimental occlusal interferences. Part Ⅱ. Masseteric EMG responses to an intercuspal interference. J Oral Rehabil 1995; 22: 521-31. 1) Manfredini D, Castroflorio T, Perinetti G, Guarda-Nardini L. Dental occlusion, body posture and temporomandibular disorders: where we are now and where we are heading for. J Oral Rehabil 2012; 39: 463-71. 15) Dao TT, Lavigne GJ. Oral splints: the crutches for temporomandibular disorders and bruxism? Crit Rev Oral Biol Med 1998; 9: 345-61. 26) Anderson DJ, Picton DC. Masticatory stresses in normal and modified occlusion. J Dent Res 1958; 37: 312-7. 43) Li J, Jiang T, Feng H, Wang K, Zhang Z, Ishikawa T. The electromyographic activity of masseter and anterior temporalis during orofacial symptoms induced by experimental occlusal highspot. J Oral Rehabil 2008; 35: 79-87. 38) 萩原 彰, 小林義典. ヒトの睡眠中のBruxismに関する臨床的研究 水平的実験的咬合干渉付与前, 付与後, 除去後における筋電図, 脳電図, 眼球電図, 心電図, 呼吸曲線, 臨床所見ならびに精神内分泌反応の経日的分析. 歯学 1985; 73: 946-1019. 20) Roberts CA, Tallents RH, Katzberg RW, Sanchez-Woodworth RE, Espeland MA, Handelman SL. Comparison of internal derangements of the TMJ with occlusal findings. Oral Surg Oral Med Oral Pathol 1987; 63: 645-50. 2) Türp JC, Schindler H. The dental occlusion as a suspected cause for TMDs: epidemiological and etiological considerations. J Oral Rehabil 2012; 39: 502-12. 10) Kamisaka M, Yatani H, Kuboki T, Matsuka Y, Minakuchi H. Four-year longitudinal course of TMD symptoms in an adult population and the estimation of risk factors in relation to symptoms. J Orofac Pain 2000; 14: 224-32. 18) Egermark I, Magnusson T, Carlsson GE. A 20-year follow-up of signs and symptoms of temporomandibular disorders and malocclusions in subjects with and without orthodontic treatment in childhood. Angle Orthod 2003; 73: 109-15. 14) Forssell H, Kalso E. Application of principles of evidence-based medicine to occlusal treatment for temporomandibular disorders: are there lessons to be learned? J Orofac Pain 2004; 18: 9-22. 22) Pahkala R, Qvarnström M. Can temporomandibular dysfunction signs be predicted by early morphological or functional variables? Eur J Orthod 2004; 26: 367-73. 49) Kirveskari P, Alanen P, Jämsä T. Association between craniomandibular disorders and occlusal interferences. J Prosthet Dent 1989; 62: 66-9. 50) Kirveskari P, Alanen P, Jämsä T. Association between craniomandibular disorders and occlusal interferences in children. J Prosthet Dent 1992; 67: 692-6. 33) Bakke M, Møller E. Distortion of maximal elevator activity by unilateral premature tooth contact. Scand J Dent Res 1980; 88: 67-75. 24) Michelotti A, Iodice G, Piergentili M, Farella M, Martina R. Incidence of temporomandibular joint clicking in adolescents with and without unilateral posterior cross-bite: a 10-year follow-up study. J Oral Rehabil 2016; 43: 16-22. 37) Rugh JD, Barghi N, Drago CJ. Experimental occlusal discrepancies and nocturnal bruxism. J Prosthet Dent 1984; 51: 548-53. 44) Michelotti A, Cioffi I, Landino D, Galeone C, Farella M. Effects of experimental occlusal interferences in individuals reporting different levels of wake-time parafunctions. J Orofac Pain 2012; 26: 168-75. 48) Kirveskari P, Le Bell Y, Salonen M, Forssell H, Grans L. Effect of elimination of occlusal interferences on signs and symptoms of craniomandibular disorder in young adults. J Oral Rehabil 1989; 16: 21-6. |
| References_xml | – reference: 42) Michelotti A, Farella M, Steenks MH, Gallo LM, Palla S. No effect of experimental occlusal interferences on pressure pain thresholds of the masseter and temporalis muscles in healthy women. Eur J Oral Sci 2006; 114: 167-70. – reference: 23) Marklund S, Wänman A. Risk factors associated with incidence and persistence of signs and symptoms of temporomandibular disorders. Acta Odontol Scand 2010; 68: 289-99. – reference: 52) Pullinger AG, Seligman DA. Quantification and validation of predictive values of occlusal variables in temporomandibular disorders using a multifactorial analysis. J Prosthet Dent 2000; 83: 66-75. – reference: 40) Christensen LV, Rassouli NM. Experimental occlusal interferences. Part Ⅱ. Masseteric EMG responses to an intercuspal interference. J Oral Rehabil 1995; 22: 521-31. – reference: 22) Pahkala R, Qvarnström M. Can temporomandibular dysfunction signs be predicted by early morphological or functional variables? Eur J Orthod 2004; 26: 367-73. – reference: 31) Randow K, Carlsson K, Edlund J, Oberg T. The effect of an occlusal interference on the masticatory system. An experimental investigation. Odontol Revy 1976; 27: 245-56. – reference: 17) Carlsson GE, Egermark I, Magnusson T. Predictors of signs and symptoms of temporomandibular disorders: a 20-year follow-up study from childhood to adulthood. Acta Odontol Scand 2002; 60: 180-5. – reference: 5) AADR TMD Policy Statement Revision Approved by AADR Council 3/3/2010. http://www.aadronline.org/i4a/pages/index.cfm?pageid=3465 – reference: 1) Manfredini D, Castroflorio T, Perinetti G, Guarda-Nardini L. Dental occlusion, body posture and temporomandibular disorders: where we are now and where we are heading for. J Oral Rehabil 2012; 39: 463-71. – reference: 15) Dao TT, Lavigne GJ. Oral splints: the crutches for temporomandibular disorders and bruxism? Crit Rev Oral Biol Med 1998; 9: 345-61. – reference: 27) Graf H, Zander HA. Tooth contact patterns in mastication. J Prosthet Dent 1963; 13: 1055-66. – reference: 44) Michelotti A, Cioffi I, Landino D, Galeone C, Farella M. Effects of experimental occlusal interferences in individuals reporting different levels of wake-time parafunctions. J Orofac Pain 2012; 26: 168-75. – reference: 16) Mongini F. Dental abrasion as a factor in remodeling of the mandibular condyle. Acta Anat 1975; 92: 292-300. – reference: 2) Türp JC, Schindler H. The dental occlusion as a suspected cause for TMDs: epidemiological and etiological considerations. J Oral Rehabil 2012; 39: 502-12. – reference: 3) Moreno-Hay I, Okeson JP. Does altering the occlusal vertical dimension produce temporomandibular disorders? A literature review. J Oral Rehabil 2015; 42: 875-82. – reference: 7) Okeson JP. Etiology of functional disturbances in the masticatory system. In: Management of temporomandibular disorders and occlusion. 7th ed. St. Louis: Elsevier Mosby; 2013. p.102-28. – reference: 19) Magnusson T, Egermarki I, Carlsson GE. A prospective investigation over two decades on signs and symptoms of temporomandibular disorders and associated variables. A final summary. Acta Odontol Scand 2005; 63: 99-109. – reference: 14) Forssell H, Kalso E. Application of principles of evidence-based medicine to occlusal treatment for temporomandibular disorders: are there lessons to be learned? J Orofac Pain 2004; 18: 9-22. – reference: 49) Kirveskari P, Alanen P, Jämsä T. Association between craniomandibular disorders and occlusal interferences. J Prosthet Dent 1989; 62: 66-9. – reference: 43) Li J, Jiang T, Feng H, Wang K, Zhang Z, Ishikawa T. The electromyographic activity of masseter and anterior temporalis during orofacial symptoms induced by experimental occlusal highspot. J Oral Rehabil 2008; 35: 79-87. – reference: 35) Riise C, Sheikholeslam A. The influence of experimental interring occlusal contacts on the postural activity of the anterior temporal and masseter muscles in young adults. J Oral Rehabil 1982; 19: 419-25. – reference: 46) Xie Q, Li X, Xu X. The difficult relationship between occlusal interferences and temporomandibular disorder-insights from animal and human experimental studies. J Oral Rehabil 2013; 40: 279-95. – reference: 32) Funakoshi M, Fujita N, Takehana S. Relations between occlusal interference and jaw muscle activities in response to changes in head position. J Dent Res 1976; 55: 684-90. – reference: 21) Kampe T, Hannerz H. Five-year longitudinal study of adolescents with intact and restored dentitions: signs and symptoms of temporomandibular dysfunction and functional recordings. J Oral Rehabil 1991; 18: 387-98. – reference: 45) Marini I, Gatto MR, Bartolucci ML, Bortolotti F, Alessandri Bonetti G, Michelotti A. Effects of experimental occlusal interference on body posture: an optoelectronic stereophotogrammetric analysis. J Oral Rehabil 2013; 40: 509-18. – reference: 12) Greene CS, Goddard G, Macaluso GM, Mauro G. Topical review: placebo responses and therapeutic responses. How are they related? J Orofac Pain 2009; 23: 93-107. – reference: 26) Anderson DJ, Picton DC. Masticatory stresses in normal and modified occlusion. J Dent Res 1958; 37: 312-7. – reference: 41) Baba K, Ai M, Mizutani H, Enosawa S. Influence of experimental occlusal discrepancy on masticatory muscle activity during clenching. J Oral Rehabil 1996; 23: 55-60. – reference: 34) 林 清平. 実験的咬合干渉が咀嚼系に与える影響. 歯学 1982; 70: 687-764. – reference: 39) 虫本栄子, 田中久敏, 遠藤義樹, 児玉厚三, 八重樫祐成, 古和田一成. 実験的咬合干渉が咬みしめ時の咀嚼筋AIに及ぼす影響. 補綴誌 1994; 38: 738-52. – reference: 33) Bakke M, Møller E. Distortion of maximal elevator activity by unilateral premature tooth contact. Scand J Dent Res 1980; 88: 67-75. – reference: 25) Farronato G, Rosso G, Giannini L, Galbiati G, Maspero C. Correlation between skeletal Class Ⅱ and temporomandibular joint disorders: a literature review. Minerva Stomatol 2016; 65: 239-47. – reference: 18) Egermark I, Magnusson T, Carlsson GE. A 20-year follow-up of signs and symptoms of temporomandibular disorders and malocclusions in subjects with and without orthodontic treatment in childhood. Angle Orthod 2003; 73: 109-15. – reference: 38) 萩原 彰, 小林義典. ヒトの睡眠中のBruxismに関する臨床的研究 水平的実験的咬合干渉付与前, 付与後, 除去後における筋電図, 脳電図, 眼球電図, 心電図, 呼吸曲線, 臨床所見ならびに精神内分泌反応の経日的分析. 歯学 1985; 73: 946-1019. – reference: 48) Kirveskari P, Le Bell Y, Salonen M, Forssell H, Grans L. Effect of elimination of occlusal interferences on signs and symptoms of craniomandibular disorder in young adults. J Oral Rehabil 1989; 16: 21-6. – reference: 9) Kurita K, Westesson PL, Yuasa H, Toyama M, Machida J, Ogi N. Natural course of untreated symptomatic temporomandibular joint disc displacement without reduction. J Dent Res 1998; 77: 361-5. – reference: 4) Manfredini D, Lombardo L, Siciliani G. Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era? J Oral Rehabil 2017; 44: 908-23. – reference: 53) Seligman DA, Pullinger AG. Analysis of occlusal variables, dental attrition, and age for distinguishing healthy controls from female patients with intracapsular temporomandibular disorders. J Prosthet Dent 2000; 83: 76-82. – reference: 50) Kirveskari P, Alanen P, Jämsä T. Association between craniomandibular disorders and occlusal interferences in children. J Prosthet Dent 1992; 67: 692-6. – reference: 24) Michelotti A, Iodice G, Piergentili M, Farella M, Martina R. Incidence of temporomandibular joint clicking in adolescents with and without unilateral posterior cross-bite: a 10-year follow-up study. J Oral Rehabil 2016; 43: 16-22. – reference: 47) Cioffi I, Farella M, Festa P, Martina R, Palla S, Michelotti A. Short-term sensorimotor effects of experimental occlusal interferences on the wake-time masseter muscle activity of females with masticatory muscle pain. J Oral Facial Pain Headache 2015; 29: 331-9. – reference: 8) Pullinger AG, Seligman DA, Gornbein JA. A multiple logistic regression analysis of the risk and relative odds of temporomandibular disorders as a function of common occlusal features. J Dent Res 1993; 72: 968-79. – reference: 11) Sato S, Goto S, Kawamura H, Motegi K. The natural course of nonreducing disc displacement of the TMJ: relationship of clinical findings at initial visit to outcome after 12 months without treatment. J Orofac Pain 1997; 11: 315-20. – reference: 37) Rugh JD, Barghi N, Drago CJ. Experimental occlusal discrepancies and nocturnal bruxism. J Prosthet Dent 1984; 51: 548-53. – reference: 28) Schaerer P, Stallard RE. 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| Snippet | 顎関節症のリスク因子には，外傷，解剖学的因子，病態生理学的因子，心理社会学的因子など多くのものがあることが知られており，そのうち単一の因子，あるいは複数の因子の複合によって発症するものと考えられる。すなわち，顎関節症の原因は患者によって異なっており，生物心理社会学的モデル（biopsychosocial... |
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| StartPage | 36 |
| SubjectTerms | 咬合異常 因果関係 発症因子 顎関節症 |
| Title | 臨床に有用な基礎知識＞顎関節症と咬合の関係に関するup-to-dateな見解 |
| URI | https://www.jstage.jst.go.jp/article/gakukansetsu/30/1/30_36/_article/-char/ja https://cir.nii.ac.jp/crid/1390001204419744128 |
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| ispartofPNX | 日本顎関節学会雑誌, 2018/04/20, Vol.30(1), pp.36-43 |
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