Normal ve temporomandibular eklem rahatsızlığı olan bir bireylerde kondil hareketlerinin incelenmesi

Abstract

100 MRG'ler hazırlanan şablon dahilinde uzman bir hekim tarafından derecelendirilmiştir. Elde edilen Cadiax kayıtlan yorumlanmış ve MRG ile ilişkilendirilmiştir. Cadiax değerlendirilmesinde, sağlıklı bireylere ait kayıtların simetrik, normal sınırlarda olduğu gözlenmiş, çaprazlarıma izlenmemiştir. MRG ile eklem içi düzensizlik belirlenen olguların bilgisyarlı aksiyograf kayıtlarında sınırlanmalar, geliş-gidiş yollarında sapmalar, ters dönmeler, çaprazlanmalar gözlenmiştir. Eklem içi düzensizliği olan olguların Cadiax kayıtlan ile MR görüntüleri karşılaştırıldığında, bilgisayarlı aksiyograf tanıda şimdilik sınırlı değere sahiptir. Tedavi öncesi ve sonrası kayıtların saklanması ve hasta durumunun objektif olarak değerlendirilmesinde, metrik değerler verdiği için temporomandibular rahatsızlıkların ayrımlanmasında yararlı olduğunu düşünmekteyiz.101 ABSTRACT The management of Temporomandibular disorders which is a great concern for most of the population, should be multidisciplinary. Clinical examination and evaluations should focus on the determination of the affected tissues and advanced methods should be used for diagnosis. For this purpose, a general evaluation questionairre, temporomandibular joint and muscle as well as intraoral evaluation questionairres which were prepared by an expert were used. A Symptom Check List (SCL-90) was used to determine the psychological stress levels of the subjects. Cadiax device was used for the temporomandibular joint movements' registration of all subjects including the control group and a further Magnetic Resonance Imaging (MRI) evaluation was made in suspicious cases of intraarticular derangements. The results of the symptom check list evaluation questionairres of 29 patients (11 intraarticular derangements, 18 muscle soreness) and the control group consisting of 10 patients were analyzed by a One- Way Analysis of Variance (ANOVA), Bonferroni tests between groups, Chi Square analysis or Fisher's Exact Test where statistically significant. Mann Whithey-U, t-tests or Analysis of Variance were used to compare metric measurements. MR images were graded with a template, Cadiax registrations were interpreted and related with MRI by an expert.

102 The registrations for the healthy individuals were symmetrical and boundary without any crossing while limitations, deviations in pathways, rotations or crossings were observed in MRI of cases having intraarticular derangements. When the Cadiax registrations of the cases having intraarticular derangements were compared with MRI, Cadiax, a method of mandibular movement regisration, was found to have a limited value in diagnosis. It was concluded that Cadiax was beneficial in the differentiation of temporomandibular disorders since it provides metrical values in the evaluation of the cases objectively and storage of the registrations before and after treatment.103 BÖLÜM VII KAYNAKLAR 1. Agerberg G.(1974). Maximal mandibular movement in young men and women. Swed Dent J, 67:81-100 2. Agerberg G., Osterberg T. (1974). Maximal mandibular movements and symptoms of mandibular dysfunction in 70-year-old men and women. Swed Dent J, 67(3): 1- 18 3. Alsawaf M., Garlapo D.A., Gale E.N., Carter M.J. (1989). The relationship between condylar quidance and temporomandibular joint clicking. J Prosthet Dent. 61:349- 354 4. Alvarez J., Barbier L., Carmelo Martin J., Romo L., Andikoetxea B, Santamaria J. (2001). Temporomandibular arthroscopy: a retrospective clinical study (1995- 1996) of 61 cases. Med Oral, 6(5):383-390 5. American Academy of Craniomandibular Disorders (1993). Craniomandibular Disorders: Guidelines for Evaluation, Diagnosis and Management. Okeson JP ed. Chicago: Quitessence 6. Annandale T. (1887). Displacement of the interartikular cartilage of the lower jaw and its treatment by operation. Lancet, 1:41 1 7. Baily A.L., Williams M., Mattozza F., Guichard J.P., Tubiana J.M. ( 1 990). Imaging of the temporomandibular joint. Annales de Radiologic, 33:398-407 8. Barsky A.J., Klerman G.L. (1983). Overview: hypochondriasis, bodily complaints and somatic styles. American J Psychiatry, 140:273-275