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顎關節症에서 顆頭位變化에 따른 骨變化樣狀分析
Radiographic study of bone deformans on charged condylar head position in TMJ arthrosis -

치과방사선 1983년 13권 1호 p.151 ~ 162

소속 상세정보

유동수(劉東洙)/Dong Soo You

KMID : 0378219830130010151

Abstract

顎觀節撮影法 (oblique-lateral transcranial projection과 orthopantomography)으로 얻어
진 212명, 424關節, 848枚의 顎關節X線寫眞을 對象으로 顎關節淡患者에서 顆頭位變化에 따
른 頭關節關聯骨의 骨變化樣狀을 開開ㅁ時 또는 部位別로 調査集計하여 이들간의 相互.關
係를 追究하여 다음과 같은 結果를 얻었다.
1. 顎關節病患者 212名中顆頭位變化가 210:9(99.05%)에서 出現하였고, 이중 骨變化를 隨
伴한 例는 187名 (89.05%) 이었다.
2. 骨變化가 認定된 187名中顆頭位變化와 骨變化가 同時에 兩側性으로 出現한 例는 108
例 (57,75%)였고, 顆頭位變化는 兩側性이나 骨變化는 片側性인 境遇가 66(側)였으며, 反對로
顆頭位變化는 片側性이나 骨變化兩側性境遇는 11例 (5.88%)에 不過하여 顆頭位變化와 骨
變化는密接한 關係가 있음을 알 수 있었다.
3. 顆頭位變化時의 骨變化를 樣狀別出現率을 보면 關節面의 扁平化 103例(26.55%), 骨表
面의 粗造性 및 局限된 X線透過像 99례%(25.52%), 皮質骨의 肥厚像 88例 (22.68%)로 이 3
種의 變化樣狀閣에는 큰 差異가 없었고 其外顆頭의 變形 및 萎縮이 70例(18.04%), 海綿骨
部의 骨硬化像이 22例(5.67%), 邊緣部骨增生像이 6例 (1.55%)의 出現率을 보였다.
4. 顆頭位變化時의 骨變化樣狀을 出現部位別로 보면 下顎顆頭部가 51.04%, 關節隆起部가
39.20%, 關節部가 9.60%의 順이였으며 部位別顆頭位變化와 骨變化樣狀을 보면 다음과 같
다.
a) 下顎顆頭部에서의 骨變化樣狀은 關節面의 扁平化가 34.63%로 가장 높은 比率이고, 下
顎顆頭의 變形이 27.63%, 骨表面의 粗造性 및 局限된 X 線透過像이 24.32%의 順이었으며 ,
顆頭位變化는 中心咬合時는 下方移動이 41.44%로 가장 많았고, 開口時는 下顎顆頭의 移動制
限이 35.46%, 正常位가 23.51%, 下方移動位가 19.52%의 順이었다.
b) 關節隆起部에서의 變化樣狀은 友質骨의 肥厚像이 33.26%로 가장 높은 比率이고 關
節面의 扁平化가 31.16%, 骨表面의 粗造性 및 局限된 X 線透過像이 28.37%의 順이었고, 顆
頭位變化는 中心咬合時는 下方移動位가 39.81%로 가장 많았고, 開時는 下顎顆頭의 移動制限
이 24.77%로 가장 많았으며 正常位가 23.83%, 前方移動位가 22.43%의 順이었다.
c) 關節部에서의 骨藥化樣狀은 皮質骨의 肥厚像이 72.90%로가장 높은 比率이었고, 表面
의 繼造性 및 局限된 X 線透過像이 17.76%, 海綿惇部의 骨硬化像이 9.35%의 順이었고, 顆
頭位藥化는 中心咬合時는 下方移動位가 41.5%로 가장 많았으며, 開口時는 正常位가
27.78%, 下顎顆頭의 移動制限이 25.93%, 前方移動位와 下方移動位共히 19.81%의 順이었
다.
#초록#
The author analyzed the morphologic changes of bone structure from 848 radiographis
(424 joints) of 212 patients with temporomandibular joint arthrosis, which were obtained
by the oblque-lateral transcranial profection and orthopantomography.
The interelation of the bone changes and condylar head positions the results were as
follows:
1. In the 212 patients with TMJ arthrosis, 210 patients(99.05%) show the condylar
positional changes. Among them, 187 patients 989.05%) show the bone changes.
2. In TMJ arthrosis patients with bone changes, 10% patients(57.75%) show both the
condylar positional changes and bone changes. 66 patients( %) show the condylar
positional changes bilaterally and bone changes unilaterally.
On the other hand, 11 patients (5,88%) show the condylar positional changes
unilaterally and bone change bilaterally
3. The bone changes in the TMJ arthrosis patients with the condylar positional
changes were as follows :
There were the flatlenirg of articular surface in 103 cases (26.55%) the erosion in
99cases 925.52%), and the erosion in 88 cases (22.68%). There were not much
differences among the
three types of bone changes.
And the deformity in 70 cases (18.04%), the sclerosis in 22 cases(5.67%), the marginal
protiferation in 6 cases(1.55%) were seen.
4. The regions of bone changes in TMJ arthrosis patients with condylar positional
changes were as follows :
They occurred at the condyle head(51.04%), the articular eminence(39.20%) and the
articular fossa(9.60%) in that order.
The condylar positional changes and bone changes according to the regions were as
follows:
a) In the bone changes at the condyle head, the flatteming (34.6)%) was a most
frequent finding and the deformity(27.63%) the erosion(24.32%) in the order. In the
condylar positional changes, the downward positioning of condole(41.44%) was a most
frequent finding in the mouth closed state and the restricted movement within the
articular fossa(35.46%) in the mouth open state.
b) In the bone changes at the articular eminence, the eburnation(33.26%) was a most
frequent
finding and the flatteming(31.16%), the erosion(28.37%) in that order. In the condylar
positional changes, the downward positionirg of condyle(39.81%) was a most frequent
finding in the mouth closed state and the restricted movement within the articular
fossa(B4.77%) in the mouth open state.
c) In the bone changes at the articular fossa, the eburnation(72.90%) was utmost
frequent finding nd theerosion(17.76%), the sclerosis(9.35%) in that order. In the condylar
positional changes, the downward positionirg of condyle(41.5%) was a most frequent
finding in the mouth closed state and the mortal positionirg of condyle(27.78%) in the
mouth open state.