악관절원판 천공 환자의 임상적 고찰
A clinical study of the patients with disc perforation in temporomandibular joint confirmed by surgery
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김형곤/윤현중/허종기/박광호/문원규
KMID : 0386219980100010001
Abstract
Purpose: The aim of this study is to clarify the characteristic clinical features of patients with temporomandibular joint disc perforation, which will be helpful in diagnosis and management of them.
Materials and Methods: We evaluated retrospectively the clinical symptoms, such as location and severity of pain, habits, mouth opening limitation and temporomandibular joint sound. Ninety patients had perforation in the disc or retrodiscal tissue, out of 582 patients who were diagnosed as TMJ internal derangement and received surgical treatment in the TMJ clinic, Yongdong Severance Hospital, from 1992 to 1997; sixty patients with final diagnosis of anterior meniscus displacement without reduction not having any other pathosis such as adhesion, hyperemia and perforation, were used as the control group for further analysis.
Results: The chief complaint at the time of the first visit was TMJ pain(68.9%) for the perforation group and TMJ pain(51.7%) and mouth opening limitation(28.3%) for the control group. History of facial trauma(8.8% vs 3.3%) and open-lock(15.6% vs 5.0%) was more common in the perforation group than in the control group, but closed-lock history was more common in the control(38.3% vs 25.6%). Bruxism was more common in the perforation group(23.3% vs 8.3%). Mouth opening over 40mm was more significant in the perforation group(34.4%) than in the control group(16.7%). Moderate and severe TMJ pain during palpation on the TMJ area were found 28.9% and 27.8% in the perforation group and 10.0%, 3.3% in the contol group. Crepitus was found in the perforation group(34.4%) and not in the control group. Headache was not significant between two groups, but neck pain and shoulder pain were more common in the perforation group(38.9%, 37.8%) than in the control group(21.7%, 15.0%).
Conclusions: Significant findings of the perforation group were maximum mouth opening over 40㎜, crepitus, moderate and severe tenderness during palpation on the TMJ area, neck pain, shoulder pain, bruxism and/or clenching(p(0.05). Postoperative follow-up study might be necessary to clarify the above findings.
키워드
disc perforation, temporomandibular joint, TMJ surgery
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