악관절증 환자의 X선사진 판독법 개발에 관한 연구

THE DEVELOPMENT OF INTERPRETATION FOR TEMPOROMANDIBULAR JOINT ROENTGENOGRAMS

The authors analyzed the morphological change of bone structure from 3,140 radiographs (1570 joints) of 785 patients with temporomandibular joint arthrosis, which were obtained by the oblique lateral transcranial projection and orthopantomographs. The interrelation of bone change and clinical symptoms, duration of the diseases were examined. Also, the bone changes of articular eminence, condyle, articular fossa were examined according to positional change of the condyle in the mouth open and close state. The results were as follows. 1. In the 785 patients with TMJ arthrosis, 782 patients (99.62%) show the positional change of the condyle. Among them 691 patients (88.03%) show the bone change. 2. In TMJ arthrosis patients with bone changes 451 patients (65.27%) showed both the condylar positional changes and bone changes bilaterally. 198 patients (28.65%) show the condylar positional changes bilaterally and bone changes unilaterally. 3. The bone changes in the TMJ arthrosis were in order of frequency eburnation (647 cases, 32.8%), erosion (548 cases, 27.79%), flattening (418 cases, 21.20%), deformity (138 cases, 6.99%). sclerosis (115 cases, 5.83%), marginal proliferation (106 cases, 5.38%). The region of bone change in TMJ arthrosis with condylar positional changes were in order of frequency the articular eminence (43.97%) condylar head (38.64%), articular fossa (17.39%). In the patients with bone changes, their clinical symptoms were pain (44.34%), clicking sound (33.5%), limitation of mouth opening (22.52%). In the patients complaining pain the most frequent bone change was erosion (28.60%), in the patients complaining clicking sound, eburnation (28.97%) in the patients complaining the limitation, eburnation (29.40%). Also in the patients with the duration below 1 year most common bone change was eburnation. 5. The most common condylar positional change was downward position (39.94%) in closed state, restricted movement of condyle (30.07%) in open state. The condylar positional changes and bone changes according to the region were as follows: a) In the condylar head the most frequent bone change was erosion (30.45%) and the most frequent condylar positional change was downward position (37.40%) in closed state, restricted movement of condyle (33.2%) in open state. b) In the articular eminence the most frequent bone change was eburnation (39.91%) and the most frequent condylar positional change was downward position (39.79%) in closed state, restricted movement of condyle (27.22%) in open state. c) In the articular fossa the most frequent bone change was eburnation (53.94%) and the most frequent condylar positional change was downward position (42.57%) in closed state, restricted movement of condyle (30.32%) in open state.