颞下颌关节紊乱病的分类、诊断及治疗进展

Update of the classification,diagnosis and management of temporomandibular disorders

近年来关于颞下颌关节紊乱病的分类和诊断已基本取得共识。颞下颌关节紊乱病是一种具有明显生物-心理-社会模式特点的心身疾病,除了临床诊断外,还要评价疼痛相关的功能丧失和心理状况。尽管外科手术治疗的水平有了很大的进步,但仍要强调治疗首选是非手术的保守治疗。相当一部分患者症状体征轻微或完全没有任何症状体征,颞下颌关节紊乱病治疗应充分考虑其症状体征对患者的影响程度,而不是仅仅根据临床诊断和影像检查结果而作出是否需要治疗的结论。

In recent years,there has been a general consensus on the classification and diagnosis of temporomandibular disorders(TMD).TMD is a psychosomatic disorder with distinct biopsychosocial characteristics.In addition to clinical diagnosis,it is essential to assess pain⁃related functional impairment and psychological conditions.Despite significant advancements in surgical techniques,it must be emphasized that conservative management remains the preferred approach.A considerable proportion of patients may exhibit mild symptoms or be entirely asymptomatic.The decision to make a treatment plan should thoroughly consider the impact of symptoms and signs on the patient rather than solely relying on clinical diagnoses and imaging results.