The condylar movements in patients with TMD Discrimination analysis for condylar translation and rotation among different diagnostic groups
It was suggested that mandibular movement disorder is closely related to the TMJ of masticatory muscle in TMD patients. However, this relationship has not been confirmed. The purpose of this study was to quantitatively evaluate the mandibular movement in TMD patients in order to elucidate the relati...
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| Published in | Journal of the Japanese Society for the Temporomandibular Joint Vol. 10; no. 2; pp. 438 - 451 |
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| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japanese Society for Temporomandibular Joint
20.09.1998
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/gakukansetsu1989.10.438 |
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| Abstract | It was suggested that mandibular movement disorder is closely related to the TMJ of masticatory muscle in TMD patients. However, this relationship has not been confirmed. The purpose of this study was to quantitatively evaluate the mandibular movement in TMD patients in order to elucidate the relationship between abnormalities of the TMJ or masticatory muscle and mandibular movement disorder. A total of 103 joints, consisting of 94 TMD joints as subjects and 9 normal joints as controls, was selected. The maximum translation and rotation of condylar movements was measured using the apparatus developed by Nagata et al. The subjects were divided into 6 subgroups, and each volume of maximum movement was statistically compared among the groups employing the discrimination analysis. The conclusions were as follows:. A marked limitation of movement was observed in the groups with abnormal TMJ. 77% of anterior disk displacement with reduction (ADD/wr), 16% of anterior disk displacement without reduction (ADD/wor), and 50% of osteoarthrosis were within normal limits in the movement volume, some of which involved an abnormal TMJ without limitation of movement. There were no significant differences in ADD/wr in comparison with the normal group. Both translation and rotation movements tended to reduce in ADD/wor compared to the normal group. There was no relationship between PD and hypermobility of TMJ. From the results, it was suggested that limitation of condylar movement related to TMJ disorders, and each disorder has a different feature of limitation. |
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| AbstractList | It was suggested that mandibular movement disorder is closely related to the TMJ of masticatory muscle in TMD patients. However, this relationship has not been confirmed. The purpose of this study was to quantitatively evaluate the mandibular movement in TMD patients in order to elucidate the relationship between abnormalities of the TMJ or masticatory muscle and mandibular movement disorder. A total of 103 joints, consisting of 94 TMD joints as subjects and 9 normal joints as controls, was selected. The maximum translation and rotation of condylar movements was measured using the apparatus developed by Nagata et al. The subjects were divided into 6 subgroups, and each volume of maximum movement was statistically compared among the groups employing the discrimination analysis. The conclusions were as follows:. A marked limitation of movement was observed in the groups with abnormal TMJ. 77% of anterior disk displacement with reduction (ADD/wr), 16% of anterior disk displacement without reduction (ADD/wor), and 50% of osteoarthrosis were within normal limits in the movement volume, some of which involved an abnormal TMJ without limitation of movement. There were no significant differences in ADD/wr in comparison with the normal group. Both translation and rotation movements tended to reduce in ADD/wor compared to the normal group. There was no relationship between PD and hypermobility of TMJ. From the results, it was suggested that limitation of condylar movement related to TMJ disorders, and each disorder has a different feature of limitation. It was suggested that mandibular movement disorder is closely related to the TMJ of masticatory muscle in TMD patients. However, this relationship has not been confirmed.The purpose of this study was to quantitatively evaluate the mandibular movement in TMD patients in order to elucidate the relationship between abnormalities of the TMJ or masticatory muscle and mandibular movement disorder.A total of 103 joints, consisting of 94 TMD joints as subjects and 9 normal joints as controls, was selected. The maximum translation and rotation of condylar movements was measured using the apparatus developed by Nagata et al. The subjects were divided into 6 subgroups, and each volume of maximum movement was statistically compared among the groups employing the discrimination analysis.The conclusions were as follows:.A marked limitation of movement was observed in the groups with abnormal TMJ.77% of anterior disk displacement with reduction (ADD/wr), 16% of anterior disk displacement without reduction (ADD/wor), and 50% of osteoarthrosis were within normal limits in the movement volume, some of which involved an abnormal TMJ without limitation of movement.There were no significant differences in ADD/wr in comparison with the normal group.Both translation and rotation movements tended to reduce in ADD/wor compared to the normal group.There was no relationship between PD and hypermobility of TMJ.From the results, it was suggested that limitation of condylar movement related to TMJ disorders, and each disorder has a different feature of limitation. TMD患者における顎運動障害の発生には, 顎関節や咀嚼筋の異常が密接に関係すると推察されるが, これらの異常と顎運動障害との関連は十分に調査されておらず, 運動障害の特徴や発生メカニズムは現在でも明らかにされていない。したがって, 本研究では, 顎関節や咀嚼筋の異常と顎運動障害との関連を明らかにする目的で, TMD患者の顎運動の定量的な評価を行った。被験対象としてTMD関節94関節を選択し, また対照として健常関節9関節を選択した。顎運動の記録には, 永田らの開発した装置を用い, 下顎頭の最大滑走量と最大回転量を計測した。TMD患者は, 咀嚼筋と顎関節の障害に基づいて, 6つのグループに分類し, 各グループごとの最大運動量を求めるとともに, 判別解析を用いて各群問の統計学的な比較を行った。結論は以下のとおりである。・明確な運動制限は顎運動障害群のみで認められた。・円板転位復位型の77%, 円板転位非復位型の16%, 変形性関節症の50%は運動量が正常であり, 顎関節異常を有する関節でも, 運動制限を認めないものが存在することが確認された。・円板転位復位型では, 健常群よりも運動範囲が増大あるいは減少する傾向を認めなかった。・円板転位非復位型では, 健常者よりも滑走運動と回転運動が減少する傾向を認めた。・PDと過剰運動との関連は確認されなかった。以上の結果より, 運動制限には顎関節異常が関与することが示唆され, 顎関節異常に応じて, 運動制限の特徴が異なることが示された。 |
| Author | FUMA, Atushi NAGATA, Kazuhiro OHNUKI, Keisuke |
| Author_FL | 永田 和裕 府馬 敦 大貫 桂輔 |
| Author_FL_xml | – sequence: 1 fullname: 府馬 敦 – sequence: 2 fullname: 永田 和裕 – sequence: 3 fullname: 大貫 桂輔 |
| Author_xml | – sequence: 1 fullname: NAGATA, Kazuhiro organization: The Nippon Dental University, School of Dentistry at Niigata – sequence: 1 fullname: OHNUKI, Keisuke organization: The Nippon Dental University, School of Dentistry at Niigata – sequence: 1 fullname: FUMA, Atushi organization: The Nippon Dental University, School of Dentistry at Niigata |
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| DOI | 10.11246/gakukansetsu1989.10.438 |
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| DocumentTitleAlternate | 滑走量と回転量による病態問の比較 ＴＭＤ患者の下顎頭運動 滑走量と回転量による病態間の比較 Discrimination analysis for condylar translation and rotation among different diagnostic groups |
| DocumentTitle_FL | ＴＭＤ患者の下顎頭運動 滑走量と回転量による病態間の比較 |
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| PublicationTitle | Journal of the Japanese Society for the Temporomandibular Joint |
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| PublicationTitle_FL | J. Jpn Soc T.M.J 日顎誌 日本顎関節学会雑誌 |
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| Publisher | The Japanese Society for Temporomandibular Joint 一般社団法人 日本顎関節学会 |
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| References | 15) 野崎真弘, 矢谷博文, 前川賢治, ほか: 臨床症状による顎関節内障の診断精度. 顎頭蓋誌 8: 43-52, 1995. 8) 岡野友宏: 画像診断機器による顎関節像. 顎関節小事典, 上村修三郎, 杉崎正志, 柴田孝典編著, 日本歯科評論社, 東京, 1990, 238-243. 28) 木本克彦, 玉置勝司, 青木英夫: 顎関節雑音による顎関節内部の機能異常に関する研究 時系列による周波数分析法の試み. 日顎誌 6: 469-481, 1994. 19) Kopp S., Wenneberg B: Intra-and interobserver variability in the assessment of signs of disorder in the stomatognathic system. Swedish Dent J 7: 239-246, 1983. 12) 細田 裕: 顎関節内障における顎関節腔内病変と顎運動の関連性に関する研究. 補綴誌 40: 122-132, 1996. 14) 近藤寿郎, 小林 馨, 鹿島隆正, ほか: 顎関節・上関節腔鏡視下剥離授動術の術後成績に関する臨床的検討. 日口科誌 40: 249-262, 1991. 1) 永田和裕, 旗手 敏: 顎関節音と下顎頭運動の同時記録解析システム システムの特徴と運動記録解析条件の検討. 日顎誌 9: 526-540, 1998. 9) 中里龍彦, 江原 茂, 玉川芳春: MRIと関節造影による顎関節症の評価. 日本医放会誌 51: 912-922, 1991. 6) 池田洋子, 木本克彦, 遠藤ゆかり, ほか: 習慣性最大開閉口運動による下顎頭の動態評価に関する研究 -左右下顎頭の滑走率差と回転率の経時的変化について-. 日顎誌 9: 120-129, 1997. 27) 志賀 博, 小林義典, 中島邦久, ほか: 顎関節音に関する臨床的研究 頭蓋下顎機能障害患者の顎関節雑音の定量的評価. 顎機能誌 2: 11-18, 1995. 4) 宮本 諭, 小川 匠, 細阻 裕, ほか: 顎関節内障患者の顎運動とMRI所見の比較検討 -顎関節円板前方転位症例について-. 補綴誌 37: 1283-1293, 1993. 16) 杉森孝志: 顎関節のhypermobility (過動性) に関する臨床的ならびにX線学的観察 日本人各年代最大開口域と関連して. 口病誌 39: 159-190, 1972. 22) Gay T.: Bertolami C. N: The acoustical characteristics of the normal and abnormal temporomandibular joint. J Oral Maxillofac Surg 45: 397-407, 1987. 18) Solberg W. K., Woo M. W., Houston J. B.: Prevalence of mandibular dysfunction in young adults. J Am Dent Assoc 98: 25-34, 1979. 36) 小林 馨, 近藤寿郎: 顎関節上関節腔線維性癒着病変の診断と治療 その1顎関節腔二重造影断層X線写真所見. 鶴見歯学 15: 163-171, 1989. 42) 甲斐貞子: 下顎過剰運動と閉口障害. 上村修三郎, 杉崎正志, 柴田孝典編著, 顎関節小事典 (II), 166-169, 東京, 日本歯科評論社, 1993. 31) 上田龍太郎, 板東永一, 中野雅徳, ほか: 顎口腔機能診断のための6自由度顎運動パラメータの検討. 補綴誌 37: 761-768, 1993. 2) 岡村敏弘, 旗手 敏: 顎関節内障における下顎頭の回転と滑走に関する二軸描記法による臨床的研究. 補綴誌 33: 1359-1373, 1989. 41) Bell W. E: Temporomandibular disorders Classification·Diagnosis·Management. Yearbook Medical Publisher Inc., Chicago, 1986, 182-198. 7) Schellhas K. P. Wilkes C. H., Omlie M. R.: The diagnosis of temporomandibular joint disease -Two compartment arthrography and MR-. Am J Roentgenol 9: 579-588, 1988. 23) 鈴木 博: 顎関節雑音の音響学的研究. 口病誌 57: 612-630, 1990. 40) Fricton J. R., Schellhas K. P., Braun B. L., et al: TMJ and craniofacial pain diagnosis and management. Ishiyaku Euro American Inc Publishers, 1988, 85-89. 5) 竹内 誠, 笹栗健一, 杉下珠美, ほか: 復位性顎関節内障患者と顎機能正常者の下顎頭運動に関する研究. 日顎誌 7: 63-74, 1995. 10) 永田和裕, 穴倉裕彌, 旗手 敏: 顎関節円板転位復位型以外のクリック症例の顎関節音と下顎頭運動の特徴. 補綴誌 41: 534-543, 1997. 38) Marguelles-Bonnet R. E., Carpentier P., Yung J. P., et al: Clinical diagnosis compared with finding of magnetic resonance imaging in 242 patients with internal derangement of the TMJ. J Orofacial Pain 9: 244-253, 1995. 34) Katzberg R. W., Dolowick M. F., Helms C. H., et al: Arthrotomography of the temprormandibular joint. Am J Roentgenol 134: 995-1003, 1980. 24) 佐野 司: 顎関節雑音の音響特性に関する研究 第2報 無症状者の音響特性の検索. 日科誌 40: 544-555, 1991. 39) Farrar W. B., McCarty W. L: Inferior joint space arthrography and characteristics of condylar paths in internal derangements of the TMJ. J prosthet Dent 41: 548-555, 1979. 20) 布袋屋啓子, 羽田 勝, 石川正俊, ほか: 臨床的に顎関節内障が疑われた患者の臨床診断の正確性について. 補綴誌 108-109, 1997. 37) 米津博文, 柴田孝典, 高橋庄二郎: 顎関節内障における関節円板動態異常の診断 (下). 日本歯科評論 549: 171-182, 1988. 29) 深川聖彦, 藤澤政紀, 鈴木卓哉, ほか: 前方整位型スプリント装着者における関節円板および下顎頭の動態. 顎機能誌 1: 159-163, 1994. 32) 加藤泰二: 下顎限界運動と最大下顎開閉口運動による顎機能診断. 補綴誌 41: 571-582, 1997. 33) Jeffrey Okeson編, 藤井弘之, 杉崎正志監訳: 口腔顔面痛の最新ガイドライン, クインテッセンス出版株式会社, 東京, 1997, 150-165. 26) Tallents R. H., Hatala M., Katzberg R. W., et al: Temporomandibular joint sound in asymptomatic volunteers. J Prosthet Dent 69: 298-303, 1993. 21) 高橋克弥: 顎関節音に関する研究. 歯学 73: 420-445, 1985. 25) 佐野 司, 道 健一: 顎関節雑音の診断 音響特性と病態の関連について. 歯科展望 82: No2, 409-417, 1993. 13) 瀬上夏樹, 村上健一郎, 藤村和磨, ほか: 顎関節内障クローズドロック症例の関節鏡視所見. 日口科誌 38: 857-869, 1989. 3) 和嶋浩一, 野本種邦: 名波智章, ほか: 非接触下顎運動測定による顎関節内障における関節円板の動態検査. 日顎誌 4: 358-368, 1992. 35) 瀬上夏樹, 福田道男, 華房秀樹, ほか: 顎関節症患者に対する顎関節腔造影の検討. 日科誌 36: 551-557, 1987. 17) Eriksson L., Westesson P.-L.: Clinical and radiological study of patients with anterior disc displacement of the temporomandibular joint. Swedish Dent J 7: 55-64, 1983. 11) 大西正俊: 顎関節鏡視法の開発とその臨床応用. 日口腔会誌 31: 487-512, 1982. 30) Pullinger A. G., SHU-PAOLIU, Low G., et al: Differences between sexes in maximum jaw opening when corrected to size. J Oral Rehabil 14: 291-299, 1987. |
| References_xml | – reference: 16) 杉森孝志: 顎関節のhypermobility (過動性) に関する臨床的ならびにX線学的観察 日本人各年代最大開口域と関連して. 口病誌 39: 159-190, 1972. – reference: 19) Kopp S., Wenneberg B: Intra-and interobserver variability in the assessment of signs of disorder in the stomatognathic system. Swedish Dent J 7: 239-246, 1983. – reference: 29) 深川聖彦, 藤澤政紀, 鈴木卓哉, ほか: 前方整位型スプリント装着者における関節円板および下顎頭の動態. 顎機能誌 1: 159-163, 1994. – reference: 28) 木本克彦, 玉置勝司, 青木英夫: 顎関節雑音による顎関節内部の機能異常に関する研究 時系列による周波数分析法の試み. 日顎誌 6: 469-481, 1994. – reference: 38) Marguelles-Bonnet R. E., Carpentier P., Yung J. P., et al: Clinical diagnosis compared with finding of magnetic resonance imaging in 242 patients with internal derangement of the TMJ. J Orofacial Pain 9: 244-253, 1995. – reference: 2) 岡村敏弘, 旗手 敏: 顎関節内障における下顎頭の回転と滑走に関する二軸描記法による臨床的研究. 補綴誌 33: 1359-1373, 1989. – reference: 4) 宮本 諭, 小川 匠, 細阻 裕, ほか: 顎関節内障患者の顎運動とMRI所見の比較検討 -顎関節円板前方転位症例について-. 補綴誌 37: 1283-1293, 1993. – reference: 36) 小林 馨, 近藤寿郎: 顎関節上関節腔線維性癒着病変の診断と治療 その1顎関節腔二重造影断層X線写真所見. 鶴見歯学 15: 163-171, 1989. – reference: 33) Jeffrey Okeson編, 藤井弘之, 杉崎正志監訳: 口腔顔面痛の最新ガイドライン, クインテッセンス出版株式会社, 東京, 1997, 150-165. – reference: 12) 細田 裕: 顎関節内障における顎関節腔内病変と顎運動の関連性に関する研究. 補綴誌 40: 122-132, 1996. – reference: 31) 上田龍太郎, 板東永一, 中野雅徳, ほか: 顎口腔機能診断のための6自由度顎運動パラメータの検討. 補綴誌 37: 761-768, 1993. – reference: 41) Bell W. E: Temporomandibular disorders Classification·Diagnosis·Management. Yearbook Medical Publisher Inc., Chicago, 1986, 182-198. – reference: 13) 瀬上夏樹, 村上健一郎, 藤村和磨, ほか: 顎関節内障クローズドロック症例の関節鏡視所見. 日口科誌 38: 857-869, 1989. – reference: 27) 志賀 博, 小林義典, 中島邦久, ほか: 顎関節音に関する臨床的研究 頭蓋下顎機能障害患者の顎関節雑音の定量的評価. 顎機能誌 2: 11-18, 1995. – reference: 37) 米津博文, 柴田孝典, 高橋庄二郎: 顎関節内障における関節円板動態異常の診断 (下). 日本歯科評論 549: 171-182, 1988. – reference: 5) 竹内 誠, 笹栗健一, 杉下珠美, ほか: 復位性顎関節内障患者と顎機能正常者の下顎頭運動に関する研究. 日顎誌 7: 63-74, 1995. – reference: 3) 和嶋浩一, 野本種邦: 名波智章, ほか: 非接触下顎運動測定による顎関節内障における関節円板の動態検査. 日顎誌 4: 358-368, 1992. – reference: 1) 永田和裕, 旗手 敏: 顎関節音と下顎頭運動の同時記録解析システム システムの特徴と運動記録解析条件の検討. 日顎誌 9: 526-540, 1998. – reference: 34) Katzberg R. W., Dolowick M. F., Helms C. H., et al: Arthrotomography of the temprormandibular joint. Am J Roentgenol 134: 995-1003, 1980. – reference: 35) 瀬上夏樹, 福田道男, 華房秀樹, ほか: 顎関節症患者に対する顎関節腔造影の検討. 日科誌 36: 551-557, 1987. – reference: 24) 佐野 司: 顎関節雑音の音響特性に関する研究 第2報 無症状者の音響特性の検索. 日科誌 40: 544-555, 1991. – reference: 8) 岡野友宏: 画像診断機器による顎関節像. 顎関節小事典, 上村修三郎, 杉崎正志, 柴田孝典編著, 日本歯科評論社, 東京, 1990, 238-243. – reference: 25) 佐野 司, 道 健一: 顎関節雑音の診断 音響特性と病態の関連について. 歯科展望 82: No2, 409-417, 1993. – reference: 18) Solberg W. K., Woo M. W., Houston J. B.: Prevalence of mandibular dysfunction in young adults. J Am Dent Assoc 98: 25-34, 1979. – reference: 14) 近藤寿郎, 小林 馨, 鹿島隆正, ほか: 顎関節・上関節腔鏡視下剥離授動術の術後成績に関する臨床的検討. 日口科誌 40: 249-262, 1991. – reference: 32) 加藤泰二: 下顎限界運動と最大下顎開閉口運動による顎機能診断. 補綴誌 41: 571-582, 1997. – reference: 40) Fricton J. R., Schellhas K. P., Braun B. L., et al: TMJ and craniofacial pain diagnosis and management. Ishiyaku Euro American Inc Publishers, 1988, 85-89. – reference: 22) Gay T.: Bertolami C. N: The acoustical characteristics of the normal and abnormal temporomandibular joint. J Oral Maxillofac Surg 45: 397-407, 1987. – reference: 6) 池田洋子, 木本克彦, 遠藤ゆかり, ほか: 習慣性最大開閉口運動による下顎頭の動態評価に関する研究 -左右下顎頭の滑走率差と回転率の経時的変化について-. 日顎誌 9: 120-129, 1997. – reference: 30) Pullinger A. G., SHU-PAOLIU, Low G., et al: Differences between sexes in maximum jaw opening when corrected to size. J Oral Rehabil 14: 291-299, 1987. – reference: 7) Schellhas K. P. Wilkes C. H., Omlie M. R.: The diagnosis of temporomandibular joint disease -Two compartment arthrography and MR-. Am J Roentgenol 9: 579-588, 1988. – reference: 10) 永田和裕, 穴倉裕彌, 旗手 敏: 顎関節円板転位復位型以外のクリック症例の顎関節音と下顎頭運動の特徴. 補綴誌 41: 534-543, 1997. – reference: 20) 布袋屋啓子, 羽田 勝, 石川正俊, ほか: 臨床的に顎関節内障が疑われた患者の臨床診断の正確性について. 補綴誌 108-109, 1997. – reference: 15) 野崎真弘, 矢谷博文, 前川賢治, ほか: 臨床症状による顎関節内障の診断精度. 顎頭蓋誌 8: 43-52, 1995. – reference: 39) Farrar W. B., McCarty W. L: Inferior joint space arthrography and characteristics of condylar paths in internal derangements of the TMJ. J prosthet Dent 41: 548-555, 1979. – reference: 23) 鈴木 博: 顎関節雑音の音響学的研究. 口病誌 57: 612-630, 1990. – reference: 17) Eriksson L., Westesson P.-L.: Clinical and radiological study of patients with anterior disc displacement of the temporomandibular joint. Swedish Dent J 7: 55-64, 1983. – reference: 21) 高橋克弥: 顎関節音に関する研究. 歯学 73: 420-445, 1985. – reference: 26) Tallents R. H., Hatala M., Katzberg R. W., et al: Temporomandibular joint sound in asymptomatic volunteers. J Prosthet Dent 69: 298-303, 1993. – reference: 42) 甲斐貞子: 下顎過剰運動と閉口障害. 上村修三郎, 杉崎正志, 柴田孝典編著, 顎関節小事典 (II), 166-169, 東京, 日本歯科評論社, 1993. – reference: 9) 中里龍彦, 江原 茂, 玉川芳春: MRIと関節造影による顎関節症の評価. 日本医放会誌 51: 912-922, 1991. – reference: 11) 大西正俊: 顎関節鏡視法の開発とその臨床応用. 日口腔会誌 31: 487-512, 1982. |
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| Snippet | It was suggested that mandibular movement disorder is closely related to the TMJ of masticatory muscle in TMD patients. However, this relationship has not been... |
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| SubjectTerms | condylar movement analysis mandibular movement disorders 下顎頭運動解析 顎運動障害 |
| Subtitle | Discrimination analysis for condylar translation and rotation among different diagnostic groups |
| Title | The condylar movements in patients with TMD |
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