Clinical Research Of T-ScanⅢ And JVA Applied In The Temporomandibular Joint Disorder Disease Diagnosis

Objective:1.By T-scan Ⅲ measuring occlusal contact situation of temporomandibular joint disorders patients,discussion of T-ScanⅢ applications in clinical physiological approach,objective to provide an objective reference and basis for the occlusal treatment of temporomandibular joint disorders.2.Through the temporomandibular joint vibration analysis instrument (JVA) measuring temporomandibular joint sounds of temporomandibular joint disorder patients and normal subjects, analysis joint audio spectrum characteristics, to investigate the clinical value of the JVA in the diagnosis of temporomandibular joint disorder.Methods:1.We selected 10 temporomandibular joint disorders patients of Affiliated Stomatology Hospital of Kunming Medical University in 2015 from January to October,newly diagnosed and associated with the occlusal according to clinical examination and imaging examination,and did not receive any treatments 1 was male patient,9 were female, ranging from 25 to 55 years old in age,40 years on average. Then adjust occlusion according to the measured data combined with the clinical examination results.Experimental group in 3 months time as variables compare themselves.The comparison included the occlusal condition,the results of the clinical examination, and the control of the visual analogue scale(VAS) 3 months later.2.We selected 10 temporomandibular joint disorders patients of Affiliated Stomatology Hospital of Kunming Medical University in 2015 from October to December,newly diagnosed according to clinical examination and imaging examination,and did not receive any treatment.Then selected 10 normal subjects as control group, the age match the experimental group.Both groups did the largest open mouths movement consistent with system metronome rhythms closed in intercuspal position. To observe and analyze the waveform characteristics and vibration parameters of the temporomandibular joint sound, and to compare the total energy of the joint vibration, and to calculate the sensitivity and specificity of the diagnosis of temporomandibular joint vibration analysis instrument with the clinical diagnosis as the standard.3.The data was analyzed with SPSS21.0 software package,and then paired t test and two independent t test.Results:1. After occlusal adjustment, occlusal area increased to 236.00± 83.61,the before was 124.20±79.83,the difference was significant,had statistical significance (P<0.05); after occlusal adjustment,the difference of force percentage was 16.16 ± 11.15%,the before was 29.02±17.87%,the difference was significant,had statistical significance(P<0.05);the deviation of COF reduce to 5.60±2.72mm,the before is 10.00± 5.37 mm,the difference was significant,had statistical significance(P<0.05); before experiment OT was 2.39±1.72s,after experiment was 0.54±0.77s, DT was 4.22 ±2.78s,after experiment was 1.23±2.48s,the difference was significant,had statistical significance(P<0.05);the clinical examination result of treated TMD patients on the basis of the result of T-Scan III measurement and clinical examination is better;VAS before experiment was 5.24±0.35,after experiment was 2.14±0.48,the difference was significant,had statistical significance(P＜0.05).The vibration waveform of TMD patients in the joint sounds is significantly varied more than the control group;the total integral of the case group and the control group were respectively 18.93±7.64PaHz, 8.96±5.00PaHz on the left,the difference was significant,had statistical significance (P<0.05); the total integral were respectively 29.59±18.53PaHz,7.42±5.81PaHz on the right,the difference was significant,had statistical significance (P<0.05);the vibration energy of the case and the control group which was less than 300 Hz were respectively 17.68±5.86Hz,7.75±4.37 Hz on the left,the difference was significant, had statistical significance(P<0.05); the vibration energy were respectively 27.73 ± 18.87Hz,6.05±4.76 Hz on the right,the difference was significant,had statistical significance(P<0.05);the vibration energy of the case group and the control group on the left which was more than 300 Hz were respectively 1.58±1.84Hz,2.14±2.67Hz, the difference not had statistical significance(P>0.05); the vibration energy on the left were respectively 1.53±1.74Hz,1.36±1.34Hz,the difference did not have statistical significance(P>0.05);the ratio of more than 300Hz and less than 300Hz vibration energy of the case group and the control group on the left were respectively 0.16±0.09, 0.17± 0.03,the difference did not have statistical significance(P>0.05); the ratio on the right were respectively 0.19±0.19,0.32±0.22,the difference not had statistical significance(P>0.05);the peak amplitude, peak frequency, median frequency were significantly higher than those in control group,but the amplitude and peak frequency for TMD diagnosis without too much significance, and is mainly used for scientific research and meticulous classification,so do not do statistical analysis;the diagnostic sensitivity and specificity of the JVA for TMD respectively were 40%,90%.Conclusion:1. T-Scan Ⅲ helps analysis and evaluation of the occlusal situation of the temporomandibular joint disorder patients before and after treatment,and for the clinical occlusal treatment has better objective guiding significance.2. The JVA has important significance for the early diagnosis of temporomandibular joint disorders,and provides for clinical more accurate reference for judging the functional status of TMJ.