颞下颌关节紊乱病英文

TEMPOROMANDIBULARDISORDERS第1页

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

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

withmoretensermuscles第17页Morelowerininterarchdistance－－seriousteethwear第18页OcclusalfactorsLatrogenicfactors:OralmadicineProsthodonticsOrthodonticsEtiologyofTMD第19页PredisposingfactorsInitiationfactorsPerpetuatingfactorEtiologyofTMD第20页PainTMJsoundsLimitationsinmandibularrangeOthersClinicalmanifestationofTMD第21页MusclederivedpainArticularderivedpainprotectivemusclesplintinglocalmusclesorenessmyofascialpainmyospasmchronicmyosis

painhappenedindiscandligamentretrodiscitissynovitisorcapsulitisosteoarthritisClinicalmanifestationofTMD第22页DisplacementofdiscRecoverablitydiscdislocationUnrecoverabilitydiscdislocationRecoverablitydiscdislocationUnrecoverabilitydiscdislocationClinicalmanifestationofTMD第23页Antiorerdiplacementofdisc第24页Antiorerdiplacementofdisc第25页TMJsounds第26页TMJsounds第27页Hyperosteogeny&discperforationSynoviumlesionsClinicalmanifestationofTMD第28页OpeninglimitationAbnormalopeningClinicalmanifestationofTMD第29页TensiontypeheadacheMigraineOthersClinicalmanifestationofTMD第30页ClinicalexaminationofTMD第31页OpeningpatternsStraightDeviation(right&left)CorrecteddeviationOthersClinicalexaminationofTMD第32页OpeningpattenStraightDeviation(right&left)CorrecteddeviationOthersClinicalexaminationofTMD第33页ClinicalexaminationofTMD第34页ClinicalexaminationofTMD第35页ClinicalexaminationofTMD第36页ClinicalexaminationofTMD第37页患者本身条件评价（patientassessmentofcondition)：chiefcomplaints;treatmenthistory&expectation行为状态评价(behavioralstatus)：jawdisability;parafunctionalbehaviors;generalhealthbehaviors心理评价(psychologicalstatus)：depression;anxiety;somatization（精神状态躯体体现）社会心理评价(psychosocialstatus)

：pain-relatedinterferencewithdailylife,painintensityandpersistence,socialsupportClinicalexaminationofTMD第38页TreatmentofTMD第39页RelaxationsplintTreatmentofTMD第40页StabilizationsplintTreatmentofTMD第41页RepositioningsplintTreatmentofTMD第42页PivotsplintTreatmentofTMD第43页TreatmentofTMDOcclusaladjustmentSurgeryOrthodonticsProsthodontics第44页Thanks第45页下颌运动轴心►第46页