可复性关节盘前移位患者的关节音特征

Characteristics of temporomandibular joint sounds in reducible anterior disc displacement of youth

目的比较青年人可复性关节盘前移位者和无颞下颌关节症状者的颞下颌关节音,探讨其关节音频谱图的特征和临床诊断价值。方法运用BioJVA颞下颌关节振动分析仪记录21例可复性关节盘前移位患者与26例正常青年人节律性大开闭口运动中双侧颞下颌关节音;以临床诊断为标准,计算关节振动总能量,诊断可复性关节盘移位的灵敏度和特异性。结果病例组两侧颞下颌关节的振动总能量、频率小于300 Hz的振动能量、频率大于300 Hz的振动能量、频率大于300 Hz的振动能量与频率小于300 Hz的振动能量之比、峰振幅、峰频率、中间频率均明显大于对照组(P<0.05);病变关节随着关节盘移位程度的增加,各项关节振动参数也随之增加,振动总能量明显增加(P<0.05);关节振动总能量对关节盘前移位的诊断灵敏度和特异性分别为0.86和0.85。结论可复性关节盘前移位患者关节音振动的各参数明显高于正常人,不同病变阶段的关节音也不同。

Objective To compare the vibration parameters in reducible anterior disc displacement and symptomless youth, and explore the clinical diagnostic value of frequency spectrogram of temporomandibular joint （TMJ） sounds. Methods 21 youth with anterior disc displacement were included as experimental group, and 26 symptomless youth were included as control group. The joint vibrations during rhythmic maximal open-close jaw movement of all subjects were recorded. The sensitivity and specificity of total integral in diagnosis of reducible anterior disc displacement were calculated. Results All TMJ vibration parameters, include total integral, integral〈300 Hz, integral〉300 Hz, 〉300/〈300 Hz radio, peak amplitude, peak frequency and median frequency, were significantly higher in experimental group than that in control group（P〈0.05）. Along with the increasing of disc displacement degree, the TMJ vibration parameters were increasing, and total integral significantly increased （P〈0.05）. The total integral demonstrated a high sensitivity and specificity in diagnosis of anterior disc displacement with reduction （0.86 and 0.85, respectively）. Conclusion The TMJ vibration parameters are significantly higher in youth with reducible anterior disc displacement than that in symptomless youth. Different pathological stages of disc displacement show different TMJ sounds.