顎関節症の臨床的研究 : Pantograph 描記路を指標とする症型分類の試み (2)

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Patients with temporomandibular joint (TMJ) problems have often consulted our clinic, in search of the cause and remedy for their problems. This disease and dysfunction named TMJ syndrome is a condition in which painful spasm in the muscles of mastication occurs, often in association with difficulty in opening the mouth, displacement of the mandible and clicking or creptitation in the TMJ. Although clinical research and observation have been conducted for many years by various investigators, there is currently disagreement about what symptoms and findings are characteristic of and directly related to the TMJ. This phenomenon creates a disire for simplification of this multifactorial question. Simplification by classification may be of value for prevention, as well as for diagnosis and treatment. Through our previous investigation of the relationship between the classification of the first symptoms and its tracing using the Stuart-Pantograph, we reported that the pantographic screening of each group was of benefit to the etiology and treatment of the TMJ syndrome. Thus, it seems reasonable to continue a series of clinical studies of the TMJ syndrome to analyze and classify different aspects. For the present paper, we investigated the response on the pantographic tracing of spasm in the external pterygoid muscle which is one of the etiological factor of the TMJ syndrome, and compared with the previous data. Obtained results were as follows : 1. A large percentage (68.4%) of spasm occurred at the external pterygoid muscle. 2. Anterior Horizontal Plane (AHP) The distance of the mandibular direction of the spasm group was significantly higher than those of the control and the non-spasm group. The PCNW area of the spasm group (affected side) was significantly higher than that of the control. 3. Posterior Vertical Plane (PVP) The classification of the Fisher's angle between the spasm group (affected side) and the other groups were quite different. Approximately 50% of the spasm group showed the D∿F type (the negative Fisher's angle) and 28.2% of its classification of the protrusive path indicated the D type (irregular type). 4. Posterior Horizontal Plane (PHP) The B type (immediate side shift) was greater in the classification of the side shift and occurred in 38.5% of the spasm group (affected side). The D type (double curved type) of the classification of the working path was frequent in the spasm group (non-affected side). 5. Curve Variation Index (CVI) The CVI of the TMJ patients were higher than that of the control and lacked smoothness in all the tracings. 6. It was confirmed that all the tracings (especially the protrusive path) of the TMJ patients were affected by spasm of the external pterygoid muscle. The pantographic screening was useful for speculating the anomaly of the external pterygoid muscle and for choosing the treatment procedures.
九州歯科学会の論文
1980-09-25

顎関節症の臨床的研究 : Pantograph 描記路を指標とする症型分類の試み (2)

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