顳下頜關(guān)節(jié)紊亂病英文

TEMPOROMANDIBULARDISORDERS第1頁(yè)

AmericanDentalAssociation,1983definedTMDasagroupoforofacialdisorderscharacterizedby:Paininthepreauriculararea,TMJ,ormusclesofmasticationLimitations/deviationsinmandibularrangeofmotionTMJsoundsduringjawfunction1990YCraniomandibularDisorders(CMD)Definition第2頁(yè)EpidemiologyofTMDTMDpainhasbeenestimatedtoaffect10%(5-12%)ofthepopulationItisatleasttwiceascommoninwomenasinmenItoccursmorefrequentlyinpeople20-50yearsold第3頁(yè)AnatomyofTMJMandibularcondyleJointsurfaceoftemporalboneArticulardiscTMJcapsuleTMJligament第4頁(yè)Multi-axis&multi-direction

?MovementagilityAimportantpartinstomatognathicsystem?AremodelinginalllifetimejointAnatomyofTMJ第5頁(yè)Sagittalplaneview:Therelationshipamongdics&condyle&glenoidinCOPNormal:Oneplane:frontbevelofcondyle/middlepartofdisc/posteriorbevelofnodeOneline:crossridgeofcondyle/posteriorborderoflaterbeltofdisc/peakofglenoidAbnormal:1.Retrusionofcondyle2.HyperfunctionoflateralpterygoidmuscleAnatomyofTMJ第6頁(yè)Coronalplaneview:therelationshipofdisc&condyle&nodeinCOPNormal:middlepositioncondyleanddiscinmiddlepositionAbnormal:Ingressionorout-shiftofcondyleanddiscAnatomyofTMJ第7頁(yè)EtiologyofTMDPsychicfactorBadhabitsTraumaOthers第8頁(yè)Occlusalfactor:OcclusalinterfereProtrusiveocclusalinterfereLateralocclusalinterfereRetrusiveocclusalinterfereHighspot×occlusionEtiologyofTMD第9頁(yè)Lateralocclusalinterfere第10頁(yè)第11頁(yè)OcclusalfactorPrematurecontact：interferehappenedinPPtoICPElongationofupper3rdmolarAnteriorsuperiordisplacementofcondyleElongationoflower3rdmolarPosteriordisplacementofcondyleEtiologyofTMD第12頁(yè)OcclusalfactorMalocclusion:MalocclusionofindividualtoothMalocclusionofdentitionEtiologyofTMD第13頁(yè)Anteriorteethlingualtippingdeepoverbite第14頁(yè)OcclusalfactorMoreteethlosedLateralmolarsloss：unilateralmasticationBilateralmolarsloss：PosteriordisplacementofcondyleMaladjustmentofReversetensilereflectionEtiologyofTMD第15頁(yè)OcclusalfactorChangeofinterarchdistance:Morehigher:apertognathiaMorelower:excessivewearAnteriorinferiordisplacementofcondyleSustainedtensionofmasticationalmusclePosteriorsuperiordisplacementofcondyleMaladjustmentofreversetensilereflectionEtiologyofTMD第16頁(yè)Morehigherverticaldistance

withmoretensermuscles第17頁(yè)Morelowerininterarchdistance－－seriousteethwear第18頁(yè)OcclusalfactorsLatrogenicfactors:OralmadicineProsthodonticsOrthodonticsEtiologyofTMD第19頁(yè)P(yáng)redisposingfactorsInitiationfactorsPerpetuatingfactorEtiologyofTMD第20頁(yè)P(yáng)ainTMJsoundsLimitationsinmandibularrangeOthersClinicalmanifestationofTMD第21頁(yè)MusclederivedpainArticularderivedpainprotectivemusclesplintinglocalmusclesorenessmyofascialpainmyospasmchronicmyosis

painhappenedindiscandligamentretrodiscitissynovitisorcapsulitisosteoarthritisClinicalmanifestationofTMD第22頁(yè)DisplacementofdiscRecoverablitydiscdislocationUnrecoverabilitydiscdislocationRecoverablitydiscdislocationUnrecoverabilitydiscdislocationClinicalmanifestationofTMD第23頁(yè)Antiorerdiplacementofdisc第24頁(yè)Antiorerdiplacementofdisc第25頁(yè)TMJsounds第26頁(yè)TMJsounds第27頁(yè)Hyperosteogeny&discperforationSynoviumlesionsClinicalmanifestationofTMD第28頁(yè)OpeninglimitationAbnormalopeningClinicalmanifestationofTMD第29頁(yè)TensiontypeheadacheMigraineOthersClinicalmanifestationofTMD第30頁(yè)ClinicalexaminationofTMD第31頁(yè)OpeningpatternsStraightDeviation(right&left)CorrecteddeviationOthersClinicalexaminationofTMD第32頁(yè)OpeningpattenStraightDeviation(right&left)CorrecteddeviationOthersClinicalexaminationofTMD第33頁(yè)ClinicalexaminationofTMD第34頁(yè)ClinicalexaminationofTMD第35頁(yè)ClinicalexaminationofTMD第36頁(yè)ClinicalexaminationofTMD第37頁(yè)患者本身?xiàng)l件評(píng)價(jià)（patientassessmentofcondition)：chiefcomplaints;treatmenthistory&expectation行為狀態(tài)評(píng)價(jià)(behavioralstatus)：jawdisability;parafunctionalbehaviors;generalhealthbehaviors心理評(píng)價(jià)(psychologicalstatus)：depression;anxiety;somatization（精神狀態(tài)軀體體現(xiàn)）社會(huì)心理評(píng)價(jià)(psychosocialstatus)

：pain-relatedinterferencewithdailylife,painintensityandpersistence,socialsupportClinicalexaminationofTMD第38頁(yè)TreatmentofTMD第39頁(yè)RelaxationsplintTreatmentofTMD第40頁(yè)StabilizationsplintTreatmentofTMD第41頁(yè)RepositioningsplintTreatmentofTMD第42頁(yè)P(yáng)ivotsplintTreatmentofTMD第43頁(yè)TreatmentofTMDOcclusaladjustmentSurgeryOrthodonticsProsthodontics第44頁(yè)Thanks第45頁(yè)下頜運(yùn)動(dòng)軸心?第46頁(yè)