| Temporomandibular Jiont Internal Derangements(TMJID) is one type of the Tem po- romandibular Disorder(TMD),which is most friquently seen. Magnetic resonanc e imaging(MRI) is currently regarded as the gold standard in temporomandibular joints( TMJ)imaging. Although it suffers from such drawbacks as being expensive, necessity of advanced equipment, longer time needed to use it. By contrast, Ultra sonography(US) is a noninvasive technique enabling dynamic, real-time, convenient and cheap imaging of the TMJ, and is capable of demonstrating soft-tissue alterati ons. Recent year, Ultrasonography(US) getting more and more application in the di agnosis of TMJID.In the world,Temporomandibular Jiont Capsular Width(TMJCW) is one of the important contents for ultrasound research on TMJID. In our country, researchs on TMJCW have not been reported. This study will explore the relations hip between TMJCW and TMJID With Ultrasonography, meanwhile, we assess TMJCW as a evaluation application of TMJID therapeutic effect.First Part :The study of the correlations with TMJCW and TMJIDObjective:To explore the relationship between Temporomandibular Jiont Capsular Width(TMJCW) and Temporomandibular Jiont Internal Derangements(TMJID), and to study the application value of TMJCW inspected by ultrasound in TMJID patients.Methods:100 patients with one side TMJ suffered from TMJID and 100 volunteers without any TMJID symptom were selected in to the study. The affected TMJ and the unaffected TMJ of The TMJID patients were separately named as A1 and A2 group, meanwhile, the left TMJ and the right TMJ of the volunteers were respectively named as B1 and B2 group. All the TMJ in the four groups were examined by ultrasound, and TMJCW of each TMJ were measured respectively. At the same time, Visual Analogue Scale( VAS) and Friction index of Temporomandibular Joint Disorder(TMD) were evaluated for each TMJID patient. Compared TMJCW value among the four groups, meanwhile, analysis the correlation between D-value(between A1 and A2 group) and VAS score, and also analysis the correlation between D-value and Friction index of TMD.Results:①TMJCW mean of each group:A1=2.57±0.57 mm, A2=1.25±0.34 mm,B1=1.27±0.33 mm,B2=1.20±0.35 mm.②Compared the TMJCW value between B1 and B2 group,and there were no significant differences between them(P>0.05).③TMJCW values of A1 group were respectively compared with A2 and B1 group, the differences were significant(P < 0.05), and the TMJCW values of A1 group were increased than A2 and B1 groups(P < 0.05)④Compared the TMJCW value between A2 and B1 group,and there were no significant differences between them(P>0.05).⑤There was a positive correlation between D-value and VAS value(r = 0.85, P < 0.05). Meanwhile, D-value had a positive correlation respectively with Dysfunction Index(DI) and Craniomandibular Index(CMI)(r = 0.89, P < 0.05; r = 0.83, P < 0.05). There was weak positive correlation between D-value and Palpation Index(PI)(r = 0.24, P > 0.05).Conclusion:①The TMJCW increased in affected TMJs of TMJID patients.②There were no significant differences between unaffected TMJs of TMJID patients and TMJs of healthy people.③There were no significant differences between the left and right TMJs of healthy people.④The increased TMJCW had a positive correlation with the pain in TMJID patients.⑤The increased TMJCW had a positive correlation with the TMJID.Second Part :Observe the effects of Maitland mobilization on the treatment of patients with TMJID---use TMJCW as evaluation indexesObjective: To observe the the effects of Maitland mobilization in the treatment of Temporomandibular Jiont Internal Derangements(TMJID). methods: 60 patients with TMJID were randomly divided into observation group(n = 30) and control group(n = 30).The observation group received Maitland mobilization treatment, and the control group accepted routine ultrashort wave treatment. After 20 days, the CW、VAS score and Friction index of the temporomandibular joint(TMJ) were compared between two groups before and after treatment.Results: Before treatment, the indicators of two groups had no significant statistically difference(P>0.05). Aftr treatment, the scores of the CW、VAS and Friction index of the TMJ were significant lower in both groups,and there were statistically differences.(P<0.05).The scores of the CW、VAS and Friction index of the TMJ in observation group were both lower than that of control group(P<0.05).Conclusion: Maitland mobilization can effectively treat Temporomandibular Jiont Internal Derangements. |
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