颞下颌关节紊乱病1ppt课件.ppt

Normal position of disc close open Normal position of disc arthrography close open MRI close open condyle disc condyle disc disc Internal Derangement of TM joint disc displacement with reduction disc displacement without reduction other types of disc displacement classification disc displacement with reduction disc displacement with reduction Sign and symptom Reciprocating Clicking Arthralgia Intermittent locking Radiographic images disc displacement with reduction mild disc deformity arthrography close open MRI close open disc disc disc disc disc displacement with reduction disc displacement with reduction Treatment patient education splint arthroscopic procedure disc displacement with reduction patient education Chew bilaterally Avoid to open mouth excessly Take soft diet Change habitual nonmasticatory use of the jaws Repair of the miss teeth disc displacement with reduction repositioning splint Splint therapy arthroscopy disc displacement without reduction Limitation of mouth opening Arthralgia Persistent locking(35mm) Signs and symtoms disc displacement without reduction disc deformity degenerative changes of articular surfaces Radiographic images disc displacement without reduction arthrography close open MRI close open disc disc disc disc disc displacement without reduction Treatment disc displacement without reduction Drug therapy Arthrocentesis Splint therapy Arthroscopy Open surgery disc displacement without reduction Drug therapy Nonsteroidal anti-inlammatory drugs, NSAIDs Muscle relaxants disc displacement without reduction Arthrocentesis ---pumping Pivot splint Splint therapy arthroscopy Surgical procedures 临床分类、分型和治疗要点 咀嚼肌紊乱类 结构紊乱类 炎性疾病类 骨关节病类 1997年 马绪臣、张震康分类 临床分类、分型和治疗要点 结构紊乱类 可复性关节盘前移位 不可复性关节盘前移位 其他类型的关节盘移位 关节正常有机结构关系的改变 可复性关节盘前移位 (disc displacement with reduction) 正常 临床分类、分型和治疗要点 可复性关节盘前移位 临床特征 治疗要点 开闭口弹响 开口型异常 疼痛 间歇性锁结 健康教育 再定位合板 关节镜手术 (disc displacement without reduction) 不可复性关节盘前移