顎関節内障クローズドロック症例に対する保存療法の検討

Abstract

In our clinic, the rate of patients with temporomandibular joint (TMJ) dysfunctions amounted to 12% of all new outpatients in 1989. This report deals with general clinical aspects concerning the gender and age distribution of the TMJ patients of 1989, and evaluation of the conservative therapies which were used in the closed-lock (anterior disk displacement without reduction) cases in that year. Three hundreds eight cases of TMJ dysfunction were classified according to the criteria of the TMJ workshop 1988 : Type Ⅰ (masticatory muscle disorder)/50 cases (17%) : Type Ⅱ (traumatic arthritis)/13 cases (4%) : Type Ⅲ (internal derangement)/238 cases (76%) : Type Ⅳ (osteoarthrosis)/7 cases (2%) : and Type Ⅴ (psychic facter)/no cases (0%). Among the Type Ⅲ patient, 103 cases were diagnosed as closed-lock and conservative therapies (manipulation, manipulation assisted by pumping, and splint therapy) were performed. The efficacy of the treatment was evaluated from the viewpoint of patients' age, gender, and the periods of closed-lock before the first visit. Prognosis of the treatment was significantly associated with the gender, age, uni-or bilaterality, and history of the illness ; the symptoms of male, younger, and unilateral closed-lock patient improved faster than those of female, older and bilateral ones. Cases with shorter duration of closed-lock were observed to be more susceptible to treatment than longer ones.