正貌頭部Ｘ線規格写真分析による顎関節症患者の顎顔面形態に関する研究

Abstract

We examined facial asymmetry in patients with temporomandibular joint disorders (TMD). Cephalometric radiograms obtained from 455 patients with TMD (106 males and 349 females) and 19 controls, including 144 left, 134 right, and 177 bilateral TMD, were reviewed. Asymmetry of the middle and lower parts of the face were evaluated on the basis of landmarks on postero-anterior cephalograms. The results were as follows.1. Morphological features of all patients.1) Cephalometric indices of the patients showed a normal distribution.2) The 4 points ANS, U1, L1, Me deviated to the left.3) Some values correlated with each other.2. There was no difference in values between all patients and controls. Furthermore, there was no difference in values between the left, right, and bilateral TMD groups and the controls.3. The middle and lower third of the face in patients with left TMD patients showed a trend toward left mandibular deviation.4. The middle and lower third of the face in patients who had left or right TMD with clicking or crepitus shifted significantly to the noisy side.5. Principal component analysis revealed no obvious relation between the side affected by TMD and morphological features; however the middle and lower third of the face tended to shift slightly to the affected side.6. The middle and lower third of the face in both patients with TMD and the controls shifted to the left side. Patients with left TMD showed the most marked shift. Because of the correlations among the values, the morphological features of patients with left TMD shifted to the left. The fact that the middle and lower third third of the face shifted significantly to the side with TMJ noise indicated that facial asymmetry was related to clicking or crepitus of the TMJ.