| Summary: | 碩士 === 國立陽明大學 === 臨床牙醫學研究所 === 90 === Abstract
Internal derangement of temporomandibular joints (ID-TMJ)is part of temporomandibular disorders(TMD). For clinical application, various multifactorial models have been suggested to group patients suffering TMD for treatment need and prognosis evaluations. The factors include trauma, parafunctions, occlusion, psychological problems, oral habits…etc. Most of them except trauma, however, have remained controversy.
Factors contributing to the prevalence of ID-TMJ do not mean that they are the etiologic factors of it. In this study, we defined ID-TMJ as TMJ sounds according the gold-criteria of clinical diagnosis. The purpose of the investigation is aimed at discerning TMJ sounds and at the association among occlusion, oral habit, joint sound, TMJ pain, TMJ dysfunction, and systemic joint laxity.
A total of one hundred and twenty-nine nursing students were given a questionnaire and functional examinations. The questionnaire included items of past orofacial history, oral habits, subjective TMJ pain, subjective TMJ dysfunction. Functional examinations included overbite, overjet, lateral guidance of eccentric movement, presence of objective attrition, range of mandibular motion, active and passive mouth opening, joint palpation, muscle palpation, indirect measurement of angle of active mouth opening, and Beighton’s score records.
The result shows that the prevalence of systemic joint laxity (SJL) was 39.5% and that of internal derangement of TMJ was 63.6%. SJL was statistically correlated with ID-TMJ (P=0.023). But when we divide the subject into hypermobility group and normal group based on the cutting point defined by Beighton et al, SJL was not statistically correlated with ID-TMJ. In the presence of opening clicking, the percentage of late opening clicking was significantly higher in SJL group than normal group (P=0.023). The other factors involved in this study were not statistically correlated to the ID-TMJ. Within the limit of this study, we concluded that there is no statistically significant correlation of internal derangement (TMJ clicking sound) and systemic joint laxity.
Keywords: Internal derangement of temporomandibular disorder, systemic joint laxity, Modified Beighton’s score, occlusion, oral habit, joint sound, TMJ pain, TMJ dysfunction
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