小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 周期性疼痛
- 持续性疼痛
- 关节弹响
- 下颌动度异常
- 咀嚼肌压痛
其他诊断因素
- 抑郁或焦虑
- 头痛、背部疼痛、耳痛或颈痛
危险因素
- 女性
- 疼痛合并症
- 年龄 20-40 岁
- 抑郁，焦虑或紧张
- 遗传学
诊断性检查
首要检查
- 临床诊断
需考虑的检查
- 核磁共振成像 (MRI)
- CT 或锥形束 CT
治疗流程
颞下颌关节疼痛：发病早期
关节休息两周后仍持续疼痛
顽固性疼痛或运动障碍：骨关节炎或关节内紊乱亚型
撰稿人
作者
Andrew Sidebottom, BDS, FDSRCS, MBChB, FRCS, FRCS (OMFS)
Consultant Oral and Maxillofacial Surgeon
Spire Nottingham Hospital
Nottingham
UK
利益声明
AJS has been and continues to be reimbursed for provision of educational lectures and cadaveric training courses by the following companies: Stryker, Biomet, KLS Martin. These companies make surgical implants used during maxillofacial surgery. AJS has written patient information leaflets for EIDO on various aspects of TMJ surgery. AJS has a medicolegal practice which includes provision of expert testimony for the court related to TMD. AJS is author of a number of book chapters on management of TMD. None of the above have been influenced by the paid educational provision to the above three companies.
Nabeela Ahmed, BDS, MFDS RCS England, MBChB, FRCS (OMFS)
Consultant Maxillofacial Deformity and Trauma Surgeon
Queens Medical Centre
Nottingham
UK
利益声明
NA declares she has no competing interests.
鸣谢
Dr Andrew Sidebottom and Dr Nabeela Ahmed would like to gratefully acknowledge Dr Sandra McNeal, a previous contributor to this topic.
利益声明
SM declares that she has no competing interests.
同行评议者
Shanti Kaimal, BDS, MS
Clinical Associate Professor
Director, Advanced Education Program in Orofacial Pain
Division of TMD and Orofacial Pain
University of Minnesota
Minneapolis
MN
利益声明
鉴别诊断
- 鼻窦炎
- 冠周炎
- 慢性头痛
更多 鉴别诊断指南
- 婴儿、儿童和青少年获得性颞下颌关节紊乱病
- 应由口腔医生提出检查、诊断、治疗颞下颌关节紊乱综合征和口面部疼痛患者的建议。
更多 指南患者教育信息
颞下颌关节综合征（下颌关节弹响）
更多 患者教育信息
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