측두하악관절내장 환자의 진단분류에 따른 하악운동 특성의 분석
Analysis of the Mandibular Movements in Patients with Internal Derangement of the Temporomandibular Joint According to. Diagnostic Subgroups
백승걸, 김달웅, 박종부,
소속 상세정보
백승걸 ( ) - 경북대학교 치과대학 구강내과학
김달웅 ( ) - 경북대학교 치과대학 구강내과학
박종부 ( ) - 경북대학교 치과대학 구강내과학
KMID : 0355219980230010021
Abstract
The purpose of this study was to analyze the mandibular movements in patients with internal derangement of the temporomandibular joint according to diagnostic subgroups. The author classified the patients with internal derangement of the terrrporomandibular joint into 4 diagnostic subgroups by means of the magnet resonance imagings, and evaluated the clinical signs and the mandib ular movements with Mandibular Kinesiograph(MKG) in each subgroups. The mandib ular moverfients, measured in this study, were the types of movement in frontal and sagittal plane, velocities in opening and closing movement, and the opening and closing velocity pattern. The data were compared between the 5 groups including the normal group.
The results were as follows
1. Pain was more freguently observed in the anterior disc displacement without reduction group than in the anterior disc displacement with reduction group. Sound of joint was more frequently observed in the anterior disc displacement with reduction group, and limitation of mandibular opening movement was more frequently observed in the anterior disc displacement without reduction group. Duration of the anterior disc displacement without reduction group was significantly short compared to that of the anterior disc displacement with reduction group, and duration of the unilateral anterior disc displacement without reduction group was shortest in the experimental group. The frequency of Angle´s classifications had not significant correlations between the experimental groups.
2. Active and passive range of the opening movement, maximum protrusive movement, maximum lateral movement toward left side were significantly decreased in the experimental groups compared to the control group, but there was no significant difference in the range of the maximum lateral movement toward right side between the control and experimental groups. In unilateral anterior disc displacement without reduction group, the range of maximum lateral movement toward unaffected side was significantly decreased than that toward affeced side. But in unilateral anterior disc displacement with reduction group, there was no significant difference in the range of maximum lateral movement between toward affected side and toward unaffected side.
3. Maximum opening velocity, maximum closing velocity, average opening velocity, average closing velocity and maximum velocity of terminal tooth contact were significantly decreased in the experimental groups compared to the control group. There was no significant difference in maximum opening velocity and maximum velocity of terminal tooth contact between the subgroups of the experimental group each other, but there was significant difference in maximum closing velocity, average opening velocity and average closing velocity between the subgroups each other.
4. In the frontal plane of the MKG, the frequecy of complex deviation type (F-2) pattern was significantly increased in the anterior disc displacement without reduction group compared to the anterior disc displacement with reduction group and the control group. In the sagittal plane, the frequency of coincident type (S-1) was increased in the anterior disc displacement without reduction group, and the frequency of non-coincident type (S-2) was decreased in the same group.
5. In the maximum opening velocity pattern, the frequency of no-peak type (OV-3) in the unilateral anterior disc displacement with reduction group was significantly increased compared to the control group. The frequency of 1-peak type (OV-1) and 2-peak type (OV-2) was decreased in the anterior disc displacement without reduction group, but the frequency of no-peak type (OV-3) was increased in the same group. In the maximum closing velocity pattern, the frequency of no-peak type (CV-3) was significantly increased in the anterior disc displacement without reduction group compared to the anterior disc displacement with reduction group and the control group. The frequency of 1-peak type (CV-1) and 2-peak type (CV-2) in the anterior disc displacement with reduction group was decreased than that in the control group.
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