두경부 위치에 따른 하악운동 및 측두하악관절음의 변화

Changes of Mandibular Movement and TMJ Sound on Head and Neck Posture

The purpose of this research is to investigate the influence on mandibular movements and TMJ sounds with changes of head and neck posture. For the research, twenty patients who had complained of TMJ sounds without any other symptoms of cranio-mandibular disorders, were selected as subjects for measurements of TMJ sounds, and radiographs on transcranial view of TMJ were taken on ten of the subjects. From NHP, UHP, DHP and FHP, aspects of mandibular movement and TMJ sound were investigated from each posture. Aspects of mandibular movement and TMJ sound were observed by measuring total vibration energy(Integral), peak amplitude, maximum amound of mouth opening, and TMJ sound-emitting point using Sonopak for windows (version 1.33) and Bio-EGN(Bioresearch Inc. WI. U.S.A.). Head and neck movement-measuring instrument, CROM(perfomance attainment Inc. U.S.A.) was to maintain even head posture. Degrees of inclination of UHP and DHP were determined at 30' and distance of FHP was 4cm. The results obtained were as follows. 1. Total vibration energy and peak amplitude of TMJ sounds were decreased more on UHP and on UHP and increased more on DHP and FHP than that on NHP. 2. At the maximum mouth opening, distance of TMJ sound-emitting point were decreased more on UHP and increased more on DHP and FHP than that on NHP. 3. The amounts of the maximum mouth opening were increased more on UHP and decreased more on DHP and FHP than that on NHP. 4. For the changes of the head posture with mouth opening observed in radiograph, condylar head was positioned more lower-anteriorly on UHP, and more upper-posteriorly on DHP and FHP than that on NHP. From the results obtained as above, considering positive influence of the change of head and neck posture, avoiding down-head and forward-head posture, and recommending upper- head posture can prevent the progress of temporomandibular disorder and lead to successful treatment for the patients with temporomandibular joint sounds.