顎関節症の発症に関与するこう合因子に関する臨床的研究

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  • A Clinical Study of the Occlusal Factor Concerned with TMD.

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The purpose of this study was to clarify the relationship between TMD and occlusal contacts on dental arch. Fourty TMD patients and 12 healthy subjects as controls were examined. TMD patients were cured by occlusal adjustment of the occlusal interferences detected by biofeedback occlusal analysis. The occlusal contacts of the subjects were examined at two different occlusal positions. One was the intercuspal position (ICP), and the other was the physiological centric position (PCP) that was an extremely light tooth tapping position with the aid of EMG biofeedback.<BR>1. No significant difference was observed in the number of occlusal contacts at ICP between before and after treatment. The number at PCP was 4.2 before and 12.2 after treatment, increasing significantly after treatment (p<0.01).<BR>2. No significant differences were observed in the asymmetry index (Al) of occlusal contacts at ICP among TMD patients and healthy subjects. AI at PCP was 54.3% before and 10.8% after treatment, decreasing significantly after treatment (p<0.01). AI after treatment was not different from that (10.1%) of healthy subjects.<BR>3. In cases of palpation pains on one side, 21 (72.4%) out of 29 cases were found to be occlusal interferences on the same side observed palpation pain. Occlusal interferences were high frequently found to be in inclines that demonstrated a posterior direction of the occlusal force on mandible with signs and symptoms.<BR>These findings clearly showed that the acquisition of bilateral balanced distribution of occlusal contacts at PCP is important for the cure of TMD. It was suggested that bilateral balanced distribution of occlusal contacts is one of the normal occlusal contact patterns and there is a close relation between the location of occlusal interference and prevalence of signs and symptoms of TMD.

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