측두하악관절 내장증의 임상적 진단의 신뢰도에 관한 연구
A Study on the Reliability of Clinical Diagnosis for - TMJ Internal Derangement
김영구, 이승우, 정성창,
소속 상세정보
김영구 ( ) - 서울대학교 치과대학 구강내과
이승우 ( ) - 서울대학교 치과대학 구강내과
정성창 ( ) - 서울대학교 치과대학 구강내과
KMID : 0355219980230010037
Abstract
Temporomandibular disorders (TMD) is one of the most common chronic pain disorders in maxillofacial area, and their importance is still increasing in that the signs and symptoms of TMD are found in 30-50% of general population, and patients who need treatment are up to 3-5%.
Regardless of this high prevalence rate, various kinds of diagnostic -methods such as clinical diagnosis, radiographic diagnosis, mandibular kinesiography, thermography, electromyography, and sonography have been used as diagnostic
Thie study was supported by a grant no 02-95-361 from the SNU Hospital Research Fund.
methods in random without clear indication, and the reports about the sensitivity and specitivity of these methods show difficulty in continued application of these methods.
Before arthrogram or magnetic resonance imaging (MRI) was introduced, osseous changes and the degree of translation by orthopantomogram, transcranial view, and/or tomogram were only available information we could get.
Since arthrography has been introduced, we could know articular disc morphology and position, dynamic movement on function, articular ankylosis, and perforation on disc and/or attachment. The development of MRI made it possible for us to know borderline area between disc and attachment as well as articular morphology/position and degenerative change of bony structure. Therefore, more accurate diagnosis of TMD became possible.
But, high fee due to expensive equipment and physical trauma due to invasive procedures have become problems. Especially, injection of contrast media and repeated exposure to radiation can be harmful to the patients in arthrography. In MRI, the patients with claustrophobia and with metallic implants are contraindicated.
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