[Relationship between muscular palpation and three dimensional incisal path at border movement of mandible]

G Udagawa
Nichidai Kōkū Kagaku, Nihon University Journal of Oral Science 1989, 15 (2): 111-20
Temporomandibular arthrosis was diversified phases of its development as well as complicated mode of its crisis, due to which no concrete clinical diagnostic procedure has been established yet. However, a close relation of occlusal disturbance with the crisis factor is suggested, and assessments have been made in the prosthetic dentistry, setting a viewpoint at the phases of mandibular movement. Particularly, incisal path at border movement of mandible is made the object for basic assessment since it exhibits intensified condition. On the other hand, importance is attached to Krogh-Poulsen's muscular palpation for diagnosis of the pain and contraction of the masticatory muscle which occur in temporomandibular arthrosis. However, though there is a close relation between the pain or abnormal contraction of the masticatory muscle and the phases of mandibular movement, these diagnostic procedures have been the studies which have dealt with the subjects separately. And no report is seen on the study made of the relation between the phases of incisal path at border movement of the mandible and Krogh-Poulsen's muscular palpation. Accordingly, with the purpose of investigating these relationships, the author has made assessment of the relationship between the result by Krogh-Poulsen's muscular palpation and the form (analogue form) of three-dimensional incisal path at border movement of the mandible summarized and standardized by TMJ gnathological instrument which is evaluated as a recording method with high clinical efficiency as a method with excellent reproducibility of mandibular movement and favorable manipulability. The subjects enrolled were patients with temporomandibular arthrosis and the so-called normal healthy subjects with normally functioning occlusion who are not conscious clinically of the abnormality of the stomatognathic system nor had similar anamnesis. And the following results have been obtained. 1. Results by Krogh-Poulsen's muscular palpation; 1) The 59 so-called normal healthy subjects were classified into 2 groups by Krogh-Poulsen's muscular palpation, and of these, the cases in whom no abnormality was observed were only 5, being 8.5%, and the cases in whom single or multiple test items showed abnormality were 54, being so high rate as 91.5%. The occurring frequency of 5 test symptoms in the 54 cases were; 22 cases with trismus-40.7%; 34 cases with temporomandibular sounds -63.0%; 20 cases with pain -37.0%; 36 cases with tenderness of the lateral pterygoid muscle -66.7%; and 25 cases with disturbance of lateral mandibular movement -46.3%.(ABSTRACT TRUNCATED AT 400 WORDS)


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