下顎頭における増骨性病変 osteophyte のシュラー変法による検出能に関する実験的研究

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There are two kinds of radiographical projections, conventional and special projections, on the radiological examination of the temporomandibular joint (TMJ). It is impossible to delineate the soft tissue component of the TMJ by conventional projection. However, it is possible to present the osseous component of it by conventional projection. It is also possible to recognize the shape of the TMJ and the relationship between the condyle and the articular fossa by conventional projection. It is said that morphological abnormalities of the condyle are easily detected by the Schuller technique, which is a conventional projection of the TMJ, or by its modified technique. Morphological abnormalities of the condyle are often detected in the outside of the condyle. Hyperostosis or osteophyte develops mainly in the front surface of the condyle. There are very few experimental studies which investigated the osteophyte in the condyle and its radiological projection. Of four dried skulls, six sides of the normal TMJ were used in this study. Conical guttapercha points with diameters of 1 mm and 2 mm were used as simulate osteophytes in the condyle. Conical gutta-percha points were placed at the upper and lower margins of the anterior surfaces of the condyle and between the two margins at a 3mm interval. A modified Schuller technique, with a vertical angle of 22° and horizontal angle of 10°, and an individualized technique, with two angles of the individual condyles, were compared with regard to detection of osteophyte in the condyle in this study. The results obtained were as follows : 1. When the condyle was examined by the modified Schuller technique, the detection ratio of osteophyte, with diameters of 1 mm and 2 mm placed laterally more than 3 mm from the center of the front surface of the condyle, was 100%. 2. When the condyle was examined by the individualized technique, osteophytes with diameters 1 mm and 2 mm on the outside of the condyle were detected little and those in the most lateral side were not detected at all. 3. When the condyle was examined by the modified Schuller technique, a possibility of the detection of osteophyte was mainly due to the region rather than the size. 4. When the condyle was examined by the individualized technique, the difference within 15 degrees in the long axis angle of the condyle had little influence upon a possibility of the detection of osteophyte. 5. When the condyle was examined by the individualized technique, the radiological examination suggested that osteophytes placed laterally more than 9 mm from the center of the front surface of the condyle might be unintentionally observed as the sclerotic change in the condyle.
九州歯科学会の論文
1994-10-25

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