ガイドの位置が下顎運動に及ぼす影響　顎関節脱臼症例の治療からの観察

DOI 被引用文献6件 参考文献4件

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タイトル別名
  • Influence of changing the location of anterior guidance on mandibular movement. Clinical case of condylar dislocation.
  • —Clinical case of condylar dislocation—
  • ―顎関節脱臼症例の治療からの観察―

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Temporomandibular (TMJ) surgery is a common option in the treatment of chronic condylar dislocation, but some authors have reported disappearance of its symptomatology after occlusal therapy.<BR>A case in which condylar dislocation (CD) disappeared by changing the location of anterior guidance is presented. The patient was an 18 year-old male with an Angle class III malocclusion who had been suffering-one year - from condylar dislocation of the right TMJ upon waking up. Initially, he did not seek medical assistance for he was able to reduce it by himself. Clinical inspection showed that the mandibular right second molar was guiding mandibular eccentric movements. A stabilization splint was successfully used as therapy; within 24 hours most of the symptomatology had disappeared. Thereafter, we made removable metal appliances which fixed anterior guidance either on the canine tooth of the afflicted side or on the healthy side, and requested the patient to wear them alternately in order to determine whether changing the location of anterior guidance would contribute to the cure of CD. Moreover, we recorded jaw and condyle movements with a 6-degree-of-freedom measuring device during lateral excursions with and without wearing of the splints. By shifting anteriorly the location of tooth guidance, the range of mandibular border movements increased; and the condylar range of motion decreased during parafunctional grinding tasks. The condyle's rotation and movement became smoother and smaller within the confines of the glenoid fossa. CD of the right TMJ disappeared by shifting anteriorly the tooth guidance. We conclude that correction of anterior guidance is a non-invasive alternative therapy in some cases of condylar dislocation.

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