顳頷關節功能失調併牙齒及頸部疼痛－病例報告

本文的個案為23歲患有腦性麻痺的女性，剛開始產生的症狀為牙齒疼痛，之後雖然做了根管治療等牙齒問題的處理，還是無法減輕其疼痛，反而有日漸加劇的傾向，其主要的抱怨除了牙齒疼痛外，還有兩側顳頷關節以及頸部區域疼痛，且疼痛已嚴重影響到睡眠。物理治療的介入著重在姿勢的矯正、顳頷關節的鬆動以及頸部後方肌肉的牽拉運動及咀嚼肌群的肌力訓練，病人總共接受五次的治療，每週治療一次，在治療介入的第二週，疼痛明顯降低，不再干擾到睡眠；第三週，牙齒痛的情形消失；到了第四週，病人張嘴的大小已達正常範圍，且疼痛及壓痛點都已經消除了，可以吃任何東西而沒有限制。第五週則檢視病人對於各個回家運動的了解以及執行的正確性，讓病人回到紐西蘭後也能持續進行。個案在經過一連串的姿勢以及肌力訓練之後，其症狀獲得了極大的改善。此個案顯示出，顳頷關節功能失調所產生的症狀及頸部、牙齒疼痛可經由矯正不良姿勢及其他物理治療的方式獲得改善。

關鍵字

顳頷關節；物理治療；咀嚼肌群肌肉；姿態

並列摘要

Among patients who had temporomandibular joint dysfunction (TMD), 23% of them had neck pain and 22% had toothache. It has been reported that 85% of patients with TMD demonstrated poor posture. Forward head posture increases tensions of muscles at the posterior neck. These increasing muscle activities also result in more easily strained of the masticatory muscles which may cause TMD. Our reported case was a 23-year-old cerebral palsy who had toothache at first. Although she went to dental clinics, her pain remained and aggravated that pain area at bilateral temporomandibular joint (TMJ) and neck was also found. Physical therapy treatments included postural correction, TMJ mobilization, stretching and strengthening exercise. Patient received treatment for five times, once in a weak. At the second visit, patient no longer had sleeping disturbance; At the third visit, toothache disappeared; At the fourth weak, the range of mouth opening was normal, and tenderness points at the masticatory muscles were solved. At the last visit, home programs were checked. Our reported case showed that TMD combined with neck pain and toothache can be solved through physical therapy treatment.

並列關鍵字

Temporomandibular joint ； Physical therapy ； Masticatory muscle ； Posture

國際替代計量

顳頷關節功能失調併牙齒及頸部疼痛－病例報告

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