顎関節症における MRI 所見と臨床症状との対比
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概要
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The purpose of this study is to clarify the relationship between MRI findings and clinical symptoms in temporomandibular joint disorders. There were 78 temporomandibular joint (TMJs) from 39 patients : Males (4 or 10%) and females (35 or 90%). The youngest subject was an 11-year-old girl and the oldest subject was a 69-year-old female. The average was 30.8 years. MRI of the TMJ was obtained by a SMT-100X type (1.0T) (Shimazu Co., Kyoto, Japan) using a surface coil with a diameter of 11.5cm. A proton density weighted image (TR=1500 msec, TE=22 msec) was selected for the sequence. Sagittal planes of the TMJ in closed and open mouths and coronal planes in closed mouths were obtained. Each plane had a 3 mm thickness and a 1 mm interval. The results obtained were as follows : 1. Of the 39 patients, 19 (49%) showed a limited mouth opening as a clinical symptom. Whereas, 18 (46%) had a clicking noise on the TMJ upon opening the mouth. Four of those 18 had pain accompanied on the bilateral TMJs. Of the remaining 14, eight had the clicking noise without pain on the unilateral TMJ of the right side and the other six on the left side. 2. Of the 78 TMJs, 34 (44%) had a normal disc position and 44 (56%) had an anterior disc displacement in closed mouths. Among the 34, there was a reduction of the disc in open mouths. Of the 44, there was a reduction of the disc in open mouths among 29 (66%). However, in the other 15 (34%) there was no reduction of the disc in open mouths. 3. Of the 78 TMJs in closed mouths, 52 (67%), located on top of the mandibular condyle, showed a normal disc position. Of the remaining TMJs, 12 (15%) showed medial disc displacement and 14 (18%) showed lateral disc displacement. Of those 12, six (50%) were accompanied by anterior disc displacement. Of the 14, ten (71%) were accompanied by anterior disc displacement. 4. Of the 19 subjects, representing 38 TMJs, those with a chief complaint of limited mouth openings, 21 TMJs (55%) showed anterior disc displacement in closed mouths. Among those 21, medial and lateral disc displacement were recognized in 5 TMJs (13%). Of the 22 TMJs, which had clicking noise, 15 (68%) showed anterior disc displacement in closed mouths. A medial disc displacement was recognized in 3 TMJs (14%) and a lateral disc displacement was reconized in 5 TMJs (23%). There were 16 TMJs which had no clinical symptoms. Of the 16, nine (56%) showed anterior disc displacement. The medial disc displacement was recognized in 3 TMJs (19%) and the lateral disc displacement was recognized in 4 (25%). 5. Of the 39 eminences of the right mandibular fossa, 18 (46%) showed a high signal intensity and 21 (54%) showed a low signal intensity. Of the 39 eminences of the left mandibular fossa, 20 (51%) showed a high signal intensity and 19 (49%) showed a low signal intensity. Of the 39 right mandibular condyles, 35 (90%) showed a high signal intensity and 4 (10%) showed a low signal intensity. Of the 4, one had an erosion of the cortical bone. Of the 39 left mandibular condyles, 36 (92%) showed a high signal intensity and 3 (8%) showed a low signal intensity. Of the 3, one was accompanied by a deformity of the mandibular condyle.
- 九州歯科学会の論文
- 2000-04-25