Kinematic Analysis of Jaw Function in Young Adults in Taiwan

台灣年輕族群之下頷功能的運動學分析

顏琤嬑(Cheng-I Yen) ； 陳志豪(Chih-Hao Chen) ； 李明義(Ming-Yih Lee) ； 陳建宗(Chien-Tzung Chen)

《臺灣整形外科醫學會雜誌》 23卷3期 (2014/09) Pp. 222-231

摘要

背景：顳顎關節障礙症是由多項原因所組成的疾病，目前大多仍藉由病史及臨床症狀來診斷，傳統上常以最大張口程度來評估顳顎關節及咀嚼功能，目前仍缺乏一套完善標準的測量工具。目的及目標：本研究希望能發展一套非侵入性、可量化、具臨床應用價值的測量工具，藉以利用動力學的分析對顳顎關節及下巴活動做功能性的評估。方法：本研究收集了十八位男性及十二位女性，共三十位正常年輕受測者，我們利用Zebris系統來測量下頷髁及門齒的活動路徑，及最大張口程度。結果：最大張口程度在男性平均為46.70 ± 11.8 mm，女性為46.70 ± 6.3 mm (p = 0.783)，下頷髁在最大張嘴時的移動長度右側為11.10 ± 3.1 mm 左側為11.80 ± 3.0 mm (p = 0.076)，在下顎前突動作時下頷髁右側移動長度為2.30±1.3 mm，左側為2.30 ± 1.5 mm (p = 0.763)，兩側下頷髁及門齒移動路徑在各式下巴活動均沒有顯著差異。下巴開合週期在張嘴期及閉嘴期有不同的路徑及動力學表現，時間比約為六比四。結論：我們可利用Zebris系統對顳顎關節及下巴活動做一動態及連續性的測量，提供了動力學上的分析及生物回饋，為一非侵入性、可量化以及具臨床價值的測量工具，希望日後可應用在顳顎關節障礙症及顏面創傷病人的治療評估。

並列摘要

Background: Temporomandibular disorder (TMD) is a multifactorial disease diagnosed based on comprehensive history and clinical examination nowadays. Maximal mouth opening (MMO) has traditionally been used as an important parameter in evaluating the function of temporomandibular joint (TMJ) and masticatory muscle. However, there is still lack of an ideal method and standardized evaluation device for measurement of dynamic function of the TMJ and mandible. Aim and Objectives: The purpose of this study was to develop a clinically applicable, reliable, quantitative and noninvasive system to measure the kinematic TMJ function and jaw movement, in a dynamic and continuous way. Materials and Methods: The study group consisted of 30 young healthy adults, 18 male and 12 female. Zebris jaw motion analyzer (JMA) was used to evaluate their jaw functions, including maximum mouth opening capacity (MOC), condylar path length (CPL), and opening/closing ratio (OCR). Results: The MOC was 46.70 ± 11.8 mm in men and 46.70 ± 6.3 mm in female group (p = 0.783). For condylar range of motion, the mean CPL during mouth opening was 11.10±3.1 mm over right side and 11.80 ± 3.0 mm over left side (p = 0.076). There is no significant difference between bilateral condylar and incisal movement. The zebris JMA system showed different kinematic movement and duration of opening and closing phase in a TMJ motion cycle, with OCR about 6:4 in the study group. Conclusion: The zebris JMA system can evaluate jaw movement in a dynamic and continuous way, and it can offer the kinematic information and also has characteristics of biofeedback. In all, the JMA is a reliable, quantitative and noninvasive system to measure the TMJ function and jaw movement.

並列關鍵字

temporomandibular disorder ； maximal mouth opening ； temporomandibular joint ； jaw movement