顎關節症 X線寫眞分析에 關한 硏究
RADIOGRAPHIC ANALYSIS OF TEMPOROMANDIBULAR JOINT ARTHROSIS
치과방사선 1984년 14권 1호 p.141 ~ 152
소속 상세정보
유동수(劉東洙)/Dong Soo You
KMID : 0378219840140010141
Abstract
顎關節症患者의 X線診斷基準을 定立하기 爲하여 顎關節군으로 診斷된 259名을 對象으로
한 1,036枚의 oblique lateral transcranial projection한 필름과 orthopantomogram에서 骨의
異常像 出現樣相과 下顎頭와 關節窩間의 相對的 位置變化 出現率 및 骨異常像 出現과 下顎
의 位置異常과의 相互關係를 調査集計分析하여 다음과 같은 結論을 얻었다.
1. 顎關節症에서 骨의 X線的 變化로는 deformity 217例 (36.90%), sclerosis 201例
(34.18%), erosive change 152例 (25.85%), marginal proliferation 18例(3.06%)의 順으로 出
現하였다.
2. 下顎頭와 關節窩間의 相對的 位置變化로는 中心交合時 下顎頭의 下方移動位(34.18%)가
前方移動泣(11.22%)나 後方移動位(4.76%)보다 越等히 많았으며 顎關節症서 開節空隔의 擴大
像이 關節空隔의 狹小像보다 훨씬 많이 出現하는 X線寫眞像임을 알 수 있고,
開口時에는 不顎頭의 移動制限(35.03%)이 가장 많았으며 前方移動位(15.65%)가 下方移動
位(9.52%) 보다 많은 出現을 보여 中心咬合時와 다른 樣狀을 나타냈으며 X線寫眞像으로는
下顎頭의 不完全移動 또는 無移動이 가장 많이 出現함을 알 수 있었다.
3. 骨異常像과 下顎頭의 位置異常과의 相互關係는 中心交合時에 下方移動位와 正常範圍位
時에는 deformity가 42.79%와 37.50%로 가장 많이 出現되는 骨異常像이지만 前方移動位와
前下方移動位時에는 erosive change가 33.33%와 34.62%로 가장 많은 骨異常像이며 正常範
圍位, 前方移動位, 下方移動位時에는 deformity가 各各 38.38%, 36.96%, 44.64%로 가장 높은
出現率을 보인 骨異常像이었다.
4. 骨異常像 出現部位로는 下顎頭部(47.11%), 關節隆起部(41.50%), 關節窩部(11.39%)의 順
으로 關聯骨의 突出部에서 陷沒部에서 보다 高率의 骨異常像을 보였고 部位別 骨異常像 出
現樣狀은 下顎頭部에서는 deformity가 59.57%로 가장 많은 骨異常像으로 나타났지만 關節
隆起部와 關節窩部에서는 sclerosis가 41.39%과 65.67%로 가장 많이 出現되는 異異常像으로
나타났다.
#초록#
The author analysed the bone changes, the positional relationships between condylar
head and articular fossa, and the interrelationship between the bone changes and the
abnormal position of condylar head, from 1,036 radiographs of 259 patients with
temporomandibular joint arthrosis, which were obtained by the oblique-lateral
transcranial projection and orthopantomograms.
The results were as follows :
1. Among the radiographic bone changes of the temporomandibular joint arthrosis,
deformity was 36.90% (217 cases), sclerosis 34.18% (20 cases), errosive change 25.85%
(152 cases) and marginal proliferation 3.06% (18 cases) respectively.
2. In the positional changes between condylar head and articular fossa, the downward
positioning of condylar head in centric occlusion was most frequent (36.90%), of which
frequency was significantly higher than forward positioning (11.22%) and backward
positioning (4.76%) in same condition. Also, radiographs showed that the enlargement of
articular space showed higher frequency than its narrowing. In the opening position of
mouth, the restricted movement of condyla. head within articular fossa was most
frequent (35.03%). The forward positioning and the downward positioning was 15.65%
and 9.52% respectively. Also, radiographs revealed that the incomplete movement or no
positional change of condylar head was most frequent.
3. In the interrelationship between bone changes and abnormal position of condylar
head, deformity was 42.19% in the cases of downward positioning of condylar head in
centric occlusion and 37.50% in those of normal positioning of condylar head in same
condition. This revealed that deformity was most frequent bone change in above condyla
positioning. However, erossive change was 34.62% in the cases of downward positioning
of condylar head in centric occlusion and 33.33% in those of forward positioning. In
opening position of condylar head, and deformity in the cases of normal positioning,
forward positioning and downward positioning of condylar head was 38.38%, 36.96% and
44.64% respectively.
4. Bone changes of condylar head was 47.11%, articular eminence 41.50% and articular
fossa 11.39% respectively, This revealed that the frequencies of bone changes were
higher in the projected portion of bony structures of temporomandibular joint than their
depressed portions. On the otherhand, in the bone changes of condylar head, deformity
was 59.57% which was the most frequent. In the bone changes of articular eminence
and articular fossa, however, sclersis was 41.39% and 65.67% respectively, which was
the most frequent in those portions.
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