THE STUDY OF A JAW MOVEMENT BEFORE AND AFTER TOTAL TMJ REPLACEMENT

全颞下颌关节置换术前后下颌运动的研究

基本信息

批准号：
08457548
负责人：
SUGAHARA Toshio
金额：
$ 5.5万
依托单位：
OKAYAMA UNIVERSITY (1997)Osaka University (1996)
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1997
项目状态：
已结题

项目摘要

All joints of human body are affected by aging and some disease. They cause the morphologic and functional atrophy. The technique of artificial joint replacement has restored these collapse joints. In Japan, however, the artificial joint for the temporomandibular joint has not been developed before so that we did not have any effective treatment for the TM joints disease with the severe disorder. In this study, we presented the newest Sugahara artificial TM joints, which provides the effective ability to work in the daily life, based on the morphological analysis of human mandibular head and the dynamical factors in the jaw movement. We demonstrated the clinical application in the oral and maxillofacial field.In order to innovate artificial TM joints, we measured anatomically the TM joints taken from cadavers and human skeleton models by the reconstructive 3D-CT images. Based on the measement of the surface form of the mandibular head and the glenoid fossa, the load occurring in the pr … More ocess of chewing was analyzed by Hertz theory and the 3-dimensional finite element method. These results contributed to the first trial of Sugahara artificial TM joint for the human body.We performed this total TM joint replacement technique for the patients who have difficulty in occlusion and obstructive sleep apnea caused by chronic rheumatoid arthritis. These patients were assessed by the occlusal functional examination for chewing and the ultrasonic imaging examination, radiographic examination and measurement of jaw movement for the evaluation of TM joint movement.As a results, in the jaw movement, hinge axis movement was observed with the center of artificial TM joint. And the lateral and gliding movement were not found.According to the evaluation by the electromyogram, the activity of the both temporal and mastoid muscles got weak compared with normal one before the operation. After the operation, the activity of these muscles became weaker. It was seemed that the several months to exercise an opening mouth after the operation would be required to adapt the occlusal position given in this operation.As the anterior replacement of the jaw, the distance of the upper airway was likely to be well to breath. The patient was relived from the respiratory disturbance and also improved in speaking.As our furthermore prospect, the improvement of the form of the artificial TM joint will be discussed. This is expected to lead the high function and safer level of TM joints.Additionally, in the proces of the artificial TM joint innovatin, our new technology involving the reconstructed 3D-CT image, the contact and non-contact type-accurate 3-dimentional measuring and evaluating system, the superimposing method for evaluation, and the quantative evaluation of curved surface could realize the micro-measurement of the development process and the growth direction of the oral and maxilloafacial structure involving the maxilla, facial skelton, and plate. This study contributed to the other field research relating to oral and maxilofacial field. We were awarded the Owen Cole prize in the 8th annual meeting International Congress on Cleft Palate and Related Craniofacial Anomalies in 1997. Less

人体的所有关节都受到衰老和某些疾病的影响。它们引起形态和功能性萎缩。人造关节置换的技术恢复了这些崩溃关节。然而，在日本，颞下颌关节的人造关节以前尚未开发，因此我们对患有严重疾病的TM关节疾病没有任何有效的治疗方法。在这项研究中，我们介绍了最新的Sugahara Artistic TM关节，该关节基于人类下颌头的形态分析和颌骨运动的动态因素，提供了在日常生活中工作的有效能力。我们证明了在口腔和颌面场中的临床应用。为了使创新的人工TM关节，我们通过重建3D-CT图像从解剖学上测量了从尸体和人类骨骼模型中取出的TM关节。基于下颌头和关节叶状窝的表面形式的测量，通过Hertz理论和3维有限元方法分析了PR中发生的载荷……更多的咀嚼量。这些结果促成了Sugahara艺术TM关节的首次试验。我们为在闭塞困难和由慢性类风湿关节炎引起的阻塞性睡眠呼吸暂停的患者进行了总TM关节置换技术。通过咬合功能检查对这些患者进行咀嚼和超声成像检查，放射线检查和颌骨运动的测量，以评估TM关节运动。因此，在下颌运动中，在人工TM关节中观察到了铰链运动。并找不到侧向和滑行运动。根据肌电图评估，与手术前的正常肌肉相比，临时肌肉和乳突肌肉的活性都较弱。手术后，这些肌肉的活性变得较弱。据认为，需要在操作后进行开口嘴的几个月才能适应此操作中给出的咬合位置。当下颌的前置换时，上呼吸道的距离很可能会很好地呼吸。该患者从呼吸道灾难中重新恢复，并且在说话方面也得到了改善。此外，将讨论人造TM关节形式的改善。预计这将导致TM关节的高功能和更安全的水平。在人造TM联合创新的过程中，我们的新技术涉及重建的3D-CT图像，接触和非接触类型的3次型3维度测量和评估系统的增长方法，以及量身定量评估的量身定量评估的过程，端构成的过程是柔和的评估，该方法的量身定量的量化方法是柔和的。口服和上颌骨结构，涉及上颌骨，面部Skelton和板块。研究促进了与口腔和上叶领域有关的其他现场研究。我们在1997年举行的第8届年度会议上获得了欧文·科尔奖国际大会及相关颅面异常的奖项。