請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/28099
完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 陳韻之 | |
dc.contributor.author | Yu-Ting Chien | en |
dc.contributor.author | 簡玉婷 | zh_TW |
dc.date.accessioned | 2021-06-13T00:01:03Z | - |
dc.date.available | 2007-08-08 | |
dc.date.copyright | 2007-08-08 | |
dc.date.issued | 2007 | |
dc.date.submitted | 2007-07-30 | |
dc.identifier.citation | Adams JC. Outline of orthopaedics. 9th ed. London: Churchill Livingstone; 1981. p.70-71.
Agerberg G, Carlsson G. Functional disorders of the masticatory system. I. Distribution of symptoms according to age and sex as judged from investigation by questionnaire. Acta Odontol Scand 1972;30:597-613. Ahn SJ, Kim TW, Nahm DS. Cephalometric keys to internal derangement of temporomandibular joint in women with Class II malocclusions. Am J Orthod Dentofacial Orthop 2004;126:486-495. Ahn SJ, Lee SP, Nahm DS. Relationship between temporomandibular joint internal derangement and facial asymmetry in women. Am J Orthod Dentofacial Orthop 2005;128:583-591. Ammann P, Rizzoli R. Bone strength and its determinants. Osteoporosis Int 2003;14(suppl 3):13–18. Bernal M, Tsamtsouris A. Signs and symptoms of temporomandibular joint dysfunction in 3 to 5-year-old children. J Pedo 1986;10:127-140. Bonnick SL, Nichols DL, Sanborn CF, et al Dissimilar spine and femoral z-scores in preminopausal women. Calcif Tissue Int 1997;61:263-265. Bonnick SL. Bone densitometry in clinical practice application and interpretation. 2nd ed, Humana Press, 2004. Bouxsein ML, Marcus R. Overview of exercise and bone mass. Rheum Dis Clin North Am 1994:20:787–795. Brand JW, Nielson KJ, Tallents RH, Nanda RS, Currier GF, Owen WL. Lateral cephalometric analysis of skeletal patterns in patients with and without internal derangement of the temporomandibular joint. Am J Orthod Dentofacial Orthop 1995;107:121-128. Byun ES, Ahn SJ, Kim TW. Relationship between internal derangement of the temporomandibular joint and dentofacial morphology in women with anterior open bite. Am J Orthod Dentofacial Orthop 2005;128:87-95. Chen YJ, Gallo LM, Meier D, Palla S. Dynamic magnetic resonance imaging technique for the study of the temporomandibular joint. J Orofac Pain 2000;14:65-73. Chen YJ, Gallo LM, Palla S. The mediolateral temporomandibular joint disc position: An in vivo quantitative study. J Orofac Pain 2002;16:29-38. Chen YJ, Shih TF, Wang JS, Wang HY, Shiau YY. Magnetic resonance images of the temporomandibular joints of patients with acquired open bite. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;99:734-742. Consensus development conference: prophylaxis and treatment of osteoporosis. Am J Med 1993;94:646-650. de Bont LGM, Boering G, Liem RSB, Eulderink F, Westesson PL. Osteoarthritis and internal derangement of the temporomandibular joint: A light microscopic study. J Oral Maxillofac Surg 1986;44:634-643. de Kanter RJAM, Truin GJ, Burgersdijk RCW, et al. Prevalence in the Dutch adult population and a meta-analysis of signs and symptoms of temporomandibular disorders. J Dent Res 1993;72:1509–1518. de Leeuw R, Boering G, Stegenga B, de Bont LGM. Temporomandibular joint osteoarthrosis: clinical and radiographic characteristics 30 years after non-surgical treatment: A preliminary report. J Craniomandib Pract 1993;11:15-24. de Leeuw R, Boering G, Stegenga B, de Bont LGM. Symptoms of temporomandibular joint osteoarthrisis and internal derangement 30 years after non-surgical treatment. J Craniomandib Pract 1995;13:81-88. Dibbets JMH, van der Weele LT, Uildriks AKJ. Symptoms of TMJ dysfunction: indicators of growth patterns? J Pedodont 1985;9:265-284. Dibbets JMH, van der Weele LT. Prevalence of TMJ symptoms and x-ray findings. Eur J Orthod 1989;11:32-36. Dibbets JM, van der Weele LT. The prevalence of joint noises as related to age and gender. J Craniomandib Disord 1992;6:157–160. Dibbets JMH, van der Weele LT. Signs and symptoms of temporomandibular disorder (TMD) and craniofacial form. Am J Orthod Dentofacial Orthop 1996;110:73-78. Dolwick MF, Katzberg RW, Helms CA. Internal derangement of the temporomandibular joint. Fact or fiction? J Prosthet Dent 1983;49:415-418. Eberhard D, Bantleon H-P, Steger W. Functional magnetic resonance imaging of the temporomandibular joint disorders. European J Orthodont 2000;22:489-497. Egermark-Eriksson I, Carlsson G, Ingervall B. Prevalence of mandibular dysfunction and orofacial parafunction in 7, 11, and 15 year old Swedish children. Eur J Orthod 1981;3:163-172. Egermark-Eriksson I, Carlsson GE, Magnusson T. A long-term epidemiologic study of the relationship between occlusal factors and mandibular dysfunction in children and adolescents. J Dent Res 1987;66:67-71. Elgan C, Fridlund B. Bone mineral density in relation to body mass index among young women: A prospective cohort study. Int J Nurs Stud 2006;43:663–672. Emshoff R, Brandimaier I, Bertram S, Rudisch A. Magnetic resonance imaging findings of osteoarthrosis and effusion in patients with unilateral temporomandibular joint pain. Int J Oral Maxillofac Surg 2002;31:598-602. Eversole LR, Machado L. Temporomandibular joint internal derangements and associated neuromuscular disorders. J Am Dent Assoc 1985;110:69-79. Farrar WB, McCarty WL. Inferior joint space arthrography and characteristics of condylar paths in internal derangement of the TMJ. J Prosthet Dent 1979;41:548-555. Gambacciani M, Spinetti A, De Simone L, Cappagli B, Maffei S, Taponeco F, Fioretti P. The relative contributions of menopause and aging to postmenopausal vertebral osteopenia. J Clin Endocrinol Metab 1993;77:1148-1151. Giadarakou IK, Tallents RH, Kyrkanides S, Stein S, Moss ME. Comparison of skeletal and dental morphology in asymptomatic volunteers and symptomatic patients with bilateral disk displacement with reduction. Angle Orthod 2002;72: 541-546. Giadarakou IK, Tallents RH, Kyrkanides S, Stein S, Moss ME. Comparison of skeletal and dental morphology in asymptomatic volunteers and symptomatic patients with normal temporomandibular joints. Angle Orthod 2003a;73:116-120. Giadarakou IK, Tallents RH, Kyrkanides S, Stein S, Moss ME. Comparison of skeletal and dental morphology in asymptomatic volunteers and symptomatic patients with bilateral degenerative joint disease. Angle Orthod 2003b;73:71-78. Hatcher DC, McEvory SP, Mah RT, Faulkner MG. Distribution of local and general stress in the stomatognathic system. In Science and Practice of occlusion. Mc Neill C. Quintessence Publishing Co;1997. p. 259-270. Hemert AMV, Birkenhager JC, DE John FH, Vandenbroucke jP, Valkenburg HA. Sex hormone binding globulin in postmenopausal women: A predictor of osteoporosis superior to endogenous osteogens. Clin Endocrinology 1989;31:499-509. Horner K, Devlin H, Alsop CW, Hodgkinson IM, Adams JE. Mandibular bone mineral density as a predictor of skeletal osteoporosis. Br J Radio 1996;69:1019-1025. In memory of Cecil Steiner. Angle Orthod 1989;59:311-312. Kaneyama K, Segami N, Nishimura M, Suzuki T, Sato J. Importance of proinflammatory cytokines in synovial fluid from 121 joint with temporomandibular disorders. Br J Oral Maxillofac Surg 2002;40:418-423. Katzberg RW, Kieth DA, Guralnick WC, Manzione JV, Eick WRT. Internal derangements and arthritis of the temporomandibular joint. Radiol 1983;146:107-112. Katzberg RW, Tallents RH, Hayakawa K, Miller T, Goske MJ, Wood BP. Internal derangements of the temporomandibular joint: findings in the pediatric group. Radiol 1985;154:125-127. Katzberg RW, Westesson P-L, Tallents RH, Anderson R, Kurita K, Manzione JV, Totterman S. Temporomandibular joint: MR assessment of rotational and sideways disc displacements. Radiol 1988;169:741-748. Katzberg RW. Temporomandibular joint imaging. Radiol 1989;170:297-301. Katzberg RW, Westesson PL. Diagnosis of the Temporomandibular Joint. Philadelphia: Saunders, 1993:3–23. Katzberg RW, Westesson P-L, Tallents RH, Drake CM. Orthodontics and temporomandibular joint disorders. Am J Orthod Dentofacial Orthop. 1996;109:515–520. Kersten HCJ, Golding RP, Valk J, Van der Kwast WAM. Magnetic resonance imaging of partial temporomandibular joint disc displacement. J Oral Maxillofac Surg. 1989;47:25-29. Kircos LT, Ortendahl DA, Mark AS, Arakawa M. Magnetic resonance imaging of the TMJ disc in asymptomatic volunteers. J Oral Maxillofac Surg. 1987;45:852-854. Klemetti E, Vainio P, Kroger H. Craniomandibular disorders and skeletal mineral status. J Craniomandib Pract 1995;13:89-92. Lang SM, Moyle DD, Berg CEW, et al. Correlation of mechanical properties of vertebral trabecular bone with equivalent mineral density as measured by computed tomography. J Bone Joint Surg 1988;60:105–109. Legreel PE, Isberg A. Mandibular height asymmetry following experimentally induced temporomandibular joint disk displacement in rabbits. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86:280-285. Liel Y, Edwards J, Shary J, Spicer KM, Gordon L, Bell NH. The effects of race and body habitus on bone mineral density of the radius, hip, and spine in premenopausal women. J Clin Endocrinol Metab 1988;66:1247–1250. Lu PW, Briody JN, Ogle GD. Bone mineral density of total body, spine, and femoral neck in children and young adults: a cross-sectional and longitudinal study. J Bone Miner Res 1994;9:1451-1458. Magnusson T, Egermark-Eriksson I, Carlsson GE. Fiveyear longitudinal study of signs and symptoms of mandibular dysfunction in adolescents. J Craniomandib Pract 1986;4:338–344. Nannmark U, Sennerby L, Haraldson T. Macroscopic, Microscopic and radiologic assessment of the condylar part of the TMJ in elderly subjects. An autopsy study. Swed Dent J 1990;14:163-169. Nebbe B, Major PW, Prasad NGN, Grace M, Kamelchuk LS. TMJ internal derangement and adolescent craniofacial morphology: a pilot study. Angle Orthod 1997;67:407-414. Nebbe B, Major PW, Prasad NGN. Female adolescent facial pattern associated with TMJ disk displacement and reduction in disk length: part I. Am J Orthod Dentofacial Orthop 1999a;116: 168-176. Nebbe B, Major PW, Prasad NGN. Male adolescent facial pattern associated with TMJ disk displacement and reduction in disk length: part II. Am J Orthod Dentofacial Orthop 1999b;116:301-307. Nebbe B, Major PW. Prevalence of TMJ disk displacement in a pre-orthodontic adolescent sample. Angle Orthod 2000a;70:454-463. Nebbe B, Brooks SL, Hatcher D, Hollender LG, Prasad NGN, Major PW. Magnetic resonance imaging of the temporomandibular joint: interobserver agreement in subjective classification of disk status. Oral Surg Oral Med Oral Pathol 2000b;90:102-107. Nickerson JW, Moystad A. Observations on individuals with radiographic bilateral condylar remodeling. Cranio. 1982;1:21–37. Nilner M, Lassing S-A. Prevalence of functional disturbance and disease of the stomatognathic system in 7-14 years olds. Swed Dent J 1981;5:173-187. Okeson JP. Diagnosis of temporomandibular disorders and occlusion. In: Management of temporomandibular disorder and occlusion. 5th ed. Saint Louis: Mosby; 2003. p.321-364. Osterberg T, Carlsson G. Symptoms and signs of mandibular dysfunction in 70-year-old men and women in Gothenburg, Sweden. Commun Dent Oral Epidemiol 1979;7:315-321. Paesani D, Westesson PL, Hatala MP, Tallents RH, Brooks SL, Arbor A. Accuracy of clinical diagnosis for TMJ internal derangement and arthrosis. Oral Surg Oral Med Oral Pathol 1992;73:360-363. Pietschmann P, Resch H, Peterlik M. Etiology and pathogenesis of osteoporosis. In Orthopaedis issue in osteoporosis Yuehuei H. CRC Press;2003. p.9-10. Pocock NA, Eisman JA, Hopper JL, et al. Genetic determinants of bone mass in adults. A twin study. J Clin Invest 1987;80:706–710. Pullinger AG, Seligman DA. TMJ osteoarthrosis: A differentiation of diagnostic subgroups by symptom history and demographics. J Craniomandibular Disord Facial Oral Pain. 1987;1:251-256. Pullinger AG, Seligman DA, Solberg WK. Temporomandibular disorders. Part I: Functional status, dentomorphologic features, and sex differences in a nonpatient population. J Prosthet Dent 1988;59:228-235. Pullinger AG, Seligman DA, Gornbein JA. A multiple logistic regression analysis of the risk and relative odds of temporomandibular disorders as a function of common occlusal features. J Dent Res 1993;72:968-979. Rasmussen OC. Description of population and progress of symptoms in a longitudinal study of temporomandibular joint arthropathy. Scand J Dent Res 1981;89:196-203. Reid IR, Ames R, Evans MC, et al. Determinants of total body and regional bone density in normal postmenopausal women – a key role for fat mass. J Clin Endocrianol Metab 1992;75:45-51. Reid IR, Legge M, Stapleton JP, Evans MC, Grey AB. Regular exercise dissociates fat mass and bone density in premenopausal women. J Clin Endocrianol Metab 1995;80:1764-1768. Roberts WE, Hohlt WF, Arbuckle GR. The supporting structures and dental adaptation. In: McNeill C (ed). Science and Practice of Occlusion. Chicago: Quintessence, 1997:79–92. Rollins D, Imrhan V, Czajka-anarisa DM, Nichols DL. Lower bone mass detected at femoral neck and lumbar spine in lower-weight vs normal-weight small-boned women. J Am Diet Assoc 2003;103:742–744. Romanelli GG, Harper R, Mock D, Pharoah MJ, Tenenbaum HC. Evaluation of temporomandibular joint internal derangement. J Orofacial Pain 1997;7:254-262. Rubin LA, Hawker GA, Peltekova VD, Fielding LJ, Ridout R, Cole DEC. Determinants of peak bone mass: Clinical and genetic analysis in a young female Canadian cohort. J Bone Miner Res 1999;14:633–643. Seeman E, Hopper JL, Bach LA, et al. Reduced bone mass in daughters of women with osteoporosis. N Engl J Med 1989;320:554–558. Scellhas KP, Piper MA, Omlie MR. Facial skeleton remodeling due to temporomandibular joint degeneration: an imaging study of 100 patients. AJNR Am J Neuroradiol 1990;11:541-551. Schellhas KP, Pollei SR, Wilkes CH. Pediatric internal derangements of the temporomandibular joint: effect on facial development. Am J Orthod Dentofacial Orthop. 1993;104:51–59. Shiau YY, Chang C. An epidemiological study of temporomandibular disorders in university students of Taiwan. Community Dent Oral Epidemiol 1992;20:43-47. Slater JJRH, Lobbezoo F, Chen YJ,Naeije M. A comparative study between clinical and instrumental methods for the recognition of internal derangements with a clicking sound on condylar movement. J Orofacial Pain 2004;18:138-147. Solberg WK, Hansson TL, Nordstrom B. The temporomandibular joint in young adults at autopsy: a morphologic classification and evaluation. J Oral Rehabil 1985;12:303-321. Stewart CL, Standish SM. Osteoarthritis of the TMJ in teenaged females: report of cases. J Am Dent Assoc 1983;106:638-640. Stringert, HG, Worms FW. Variations in skeletal and dental patterns in patients with structural and functional alterations of the temporomandibular joint: a preliminary report. Am J Orthod 1986;89:285-297. Tallents RH, Guay JA, Katzberg RW, Murphy W, Proskin H. Angular and linear comparisons with unilateral mandibular asymmetry. J Craniomandib Disord Facial Oral Pain 1991;5:135-141. Tasaki MM, Westesson PL. Temporomandibular joint: diagnostic accuracy with sagittal and coronal MR imaging. Radiology 1993a;186:723-729. Tasaki MM, Westesson PL, Raubertas RF. Observer variation in interpretation of of magnetic images of the temporomandibular joint. Oral Surg Oral Med Oral Pathol 1993b;76:231-234. Tsai KS, Huang KM, Chieng PU, Su CT. Bone mineral density of normal Chinese women in Taiwan. Calcif Tissue Int 1991;48:161–166. Trpkova B, Major PW, Nebbe B, Prasad NGN. Craniofacial asymmetry and temporomandibular internal derangement in female adolescents: a posteroanterior cephalometric study. Angle Orthod 2000;70:81-88. Tucker KL, Morita K, Qiao N, Hannan MT, Cupples LA, Kiel DP. Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: Framingham osteoporosis study. Am J Clin Nutr 2006;84:936–942. Ueki K, Nakagawa K, Takatsuka S, Shimada M, Marukawa K, Takazakura D, Yamamoto E. Temporomandibular joint morphology and disc position in skeletal class III patients. Journal of Cranio-Maxillofacial Surgery 2000;28:362-368. Wang HY, Tiffany Shih TF, Wang JS, Shiau YY, Chen YJ. Low Bone Mineral Density and Temporomandibular Joint Derangement in Young Females J Orofac Pain 2007;21:143-149. Wanman A, Agerberg G. Two-year longitudinal study of signs of mandidular dysfunction in adolescents. Acta Odontol Scand 1986;44:333-342. Westesson PL, Rohlin M. Internal derangement related to osteoarthrosis in temporomandibular joint autopsy specimens. Oral Surg 1984;57:17-22. Westesson PL. Structural hard tissue changes in temporomandibular joint with internal derangement. Oral Surg Oral Med Oral Pathol 1985;59:220-224. Westesson PL. Reliability and validity of imaging diagnosis of temporomandibular joint disorder. Adv Dent Res 1993;7:137-151. World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Series 1994;843:1–129. Yamada K, Saito I, Hanada K, Hayashi T. Observation of three cases of temporomandibular joint osteoarthritis and mandibular morphology during adolescence using helical CT. J Oral Rehabil 2004;31:298–305. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/28099 | - |
dc.description.abstract | 目的︰
明顯的顳顎關節重塑現象或是嚴重的退行性關節疾病在顳顎關節內部紊亂症(ID)的患者身上並不少見,即使是在正值身體迅速增長的青春期也不例外。因此,早期發生的顳顎關節病變是否會導致疑似與下顎生長遲緩有關如不對稱下顎或骨性二級顎間關係之特殊顱顏面型態,是顱顏型態學上值得深入探討的課題。如果這些關係真實存在,顳顎關節局部破壞的嚴重度以及可能影響其嚴重度的全身性因素,例如身體質量指數(BMI)和骨質密度(BMD)等因素,其互相之間的關係為本研究的主要目的。此外,本研究亦嘗試利用上述顱顏型態學特徵與全身性體質因素發展出一套簡單又便利篩檢顳顎關節內部紊亂症嚴重度之指標。 材料和方法︰ 本實驗受測者共有156位18至30歲之年輕女性 (平均年齡為22.5 ± 2.9歲),以靜態和動態顳顎關節磁振掃描攝影進行對顳顎關節內部紊亂症的診斷,靜態顳顎關節磁振掃描影像並用來量測顳顎關節髁頭面積大小(CHA)與下顎升枝高度;以正面與側面測顱攝影評估顱顏面之形態;此外,藉由雙能量式X光骨質密度偵測儀(DXA)測得腰椎與股骨頸部的骨質密度,並於照射時同時取得身高和體重以計算身體質量指數(身高/體重2)。卡方統計、單因子變異數分析以及判別分析等統計方法用來分析上述測量變數間之關係。 結果: 於本實驗之樣本中,大部分至少一側之顳顎關節具不可復位之關節盤移位者呈現骨性二級顎間關係。上述診斷族群亦有最低之腰椎骨質密度 (0.929 ± 0.095),其次為具可復位之關節盤移位者(0.961 ± 0.083),而具正常髁盤關係者則有最高之腰椎骨質密度(0.993 ± 0.119) (單位:g/cm2)。身體質量指數和關節髁頭平均面積亦與腰椎骨質密度呈現同樣的分布趨勢,其在不可復位者、可復位者,以及正常髁盤關係者間之分布分別是18.65 ± 1.47、19.8 ± 2.5、20.86 ± 2.4(單位:Kg/m2)與0.56 ± 0.18、0.75 ± 0.15、0.82 ± 0.16(單位:cm2)。一側為正常的髁盤關係,一側為不可復位性移位關節盤者其兩側顳顎關節髁頭面積差最大;其次為一側為可復位性移位關節盤,一側為不可復位性移位關節盤者。具正常髁盤關係者的下顎升枝高度平均值最大(5.93 ± 0.43),其次分別為關節盤可復位性移位(5.7 ± 0.43)與關節盤不可復位性移位(5.5 ± 0.55)。任兩種不同關節內部紊亂狀況之間均有顯著的差異。於骨性二級顎間關係者中,關節盤為不可復位性移位者其下顎升枝高度遠較具正常髁盤關係者短,其差異高達1公分;上述差異在骨性一級與三級顎間關係者中較不明顯。顳顎關節髁頭面積及下顎升枝高度與身高、體重、身體質量指數、以及腰椎骨質密度皆有顯著的關聯性。不對稱之下顎骨似乎與兩側顳顎關節髁頭破壞程度之差異有關。 若僅以顱顏型態學與全身性體質因素等參數進行對數成敗比統計方法分析,可得出以下方程式: 篩檢指標 = -16.862–0.5795*BMI+0.3282*SNA+0.2711*ANB 根據篩檢指標來分辨受測者是否罹患至少一側之顳顎關節為不可復位之關節盤移位,其敏感度(Sensitivity)與特異度(Specificity)分別為71.4%與 89.7%。 若是將磁振掃描影像中所量得之顳顎關節定量結構參數亦放入對數成敗比統計模型,下列篩檢指標用以分辨受測者是否罹患至少一側之顳顎關節為不可復位之關節盤移位,其敏感度與特異度則可提升至81.6%與 90.7%。 篩檢指標 =-11.7954-13.4376*CHA-0.5568*BMI+0.3785*SNA 此指標方程式顯示影響關節盤是否復位的主要因素依序為: 顳顎關節髁頭面積、身體質量指數、上顎骨相對於前顱底之突出程度與上、下顎骨相對關係。 結論: 在較嚴重的顳顎關節內部紊亂症患者身上,身體質量指數與特定顱顏面型態學參數之間似乎存在某種關係。 | zh_TW |
dc.description.abstract | Objectives:
Obvious TMJ remodeling or severe degenerative joint disease (DJD) are not uncommonly seen in the patients of TMJ internal derangement (ID), even in the rapid-growing puberty stage. Therefore, whether the early-onset TMJ disorder can result in asymmetrical mandible or class II jaw relationship, which seems to be related to interfered jaw growing, deserves further investigations. The aims of this study were to explore the relationship among the severity of TMJ ID, craniofacial morphology, and systemic risk factors of TMJ ID, such as body mass index (BMI) and bone mineral density (BMD). We also wanted to develop a TMJ ID stastistical screening model by using variables derived from craniofacial morphology and systemic risk factors of TMJ ID. Materials & Methods: 156 young females (18 to 30 years old, mean age 22.5 ± 2.9) have participated to this study. Both static and dynamic TMJ MRI have been used to obtain the diagnosis of TMJ ID. The static TMJ MRI were also used to measure the cross-sectional conylar head area (CHA) and the ascending ramus height (ARH). The craniofacial morphology of the subjects were assessed by using both PA and lateral cephalograms. The bone mineral density in the lumbar spines and femoral head were obtained by using dual energy X-ray absorptiometry (DXA). The body height and weight were measured in the BMD study for calculating the BMI (height/weight2).Chi square, one way ANOVA, and logistic regression analysis were used to perform the statistical analyses. Results: From the subjects recruited for this study, most TMJ anterior disc displacement without reduction (ADDw/oR) patients have class II jaw relationship. The averaged lumbar BMD(0.929 ± 0.095,0.961 ± 0.083,0.993 ± 0.119 g/cm2), BMI (18.65 ± 1.47,19.8 ± 2.5,20.86 ± 2.4 Kg/m2)and TMJ condylar area (0.56 ± 0.18,0.75 ± 0.15,0.82 ± 0.16 cm2) are all lowest in the ADDw/oR group, followed by the disc anterior displacement with reduction (ADDwR) group, and the normal condyle/disc relationship (Normal) group. The difference of CHA between both sides TMJ is largest in patients with one normal TMJ and one TMJ with ADDw/oR, followed by patients with ADDwR and ADDw/oR in either TMJ. The ARH is largest in normal TMJ (5.93 ± 0.43 cm), followed by TMJ with ADDwR (5.7 ± 0.43 cm) and TMJ with ADDw/oR (5.5 ± 0.55). For subjects with class II jaw relationship, the averaged ARH is significantly shorter in ADDw/oR TMJ than that in the ADDwR TMJ. Such difference can be up to 1 cm. The CHA and ARH are significantly correlated with body height, body weight, BMI, and lumbar BMD. Asymmetrical mandible is associated with the side difference of condylar destruction. By using the craiofaical morphological variables and systemic risk factors, the following logistic regression model can be obtained. By using only 3 variables, namely BMI, SNA and ANB, to differentiate patients with ADDw/oR from ADDwR and Normal status, the sensitivity and specificity are up to 71.4% and 89.7%, respectively. score = -16.862–0.5795*BMI+0.3282*SNA+0.2711*ANB If we put quantitiatve measurments of the condyle and mandible, such as CHA and ARH, into the logistic regression model, the sensitivity and specificity of differentiating of subjects suffered ADDw/oR from ADDwR and Normal can be raised up to 81.6% and 90.7%, respectively, according to the following statistical model. score =-11.7954-13.4376*CHA-0.5568*BMI+0.3785*SNA It seems CHA is the most significant factor in differentiating ADDw/oR from ADDwR and Normal, followed by BMI, SNA, and ANB, respectively. Conclusions: For TMJ ID patients of certain severity, there seems to exist association between BMI and some craniofacial morphological characters. | en |
dc.description.provenance | Made available in DSpace on 2021-06-13T00:01:03Z (GMT). No. of bitstreams: 1 ntu-96-R93422012-1.pdf: 1530454 bytes, checksum: 39bff8eb62fb814668d9ae5988a9a6c6 (MD5) Previous issue date: 2007 | en |
dc.description.tableofcontents | 中文摘要 i
Abstract iii 圖目錄 v 表目錄 vi 第一章 緒論 1 第一節 背景 1 第二節 文獻回顧 2 ㄧ、顳顎關節內部紊亂症 2 二、顳顎關節內部紊亂症和退行性關節疾病 3 三、顳顎關節內部紊亂症之結構性紊亂與診斷 5 四、顳顎關節內部紊亂症與顱顏面型態之關係 6 五、顳顎關節內部紊亂症與異常咬合之關係 8 六、顳顎關節內部紊亂症與骨質密度和身體質量指數之關係 8 七、研究目的 10 第二章 實驗材料與方法 11 第一節 實驗對象的挑選 11 第二節 實驗儀器與設備 11 一、磁振掃描攝影(MRI) 11 二、測顱分析 13 三、骨質密度檢測與身體質量指數 14 第三節 實驗方法 14 磁振掃描影像解讀與診斷顳顎關節結構紊亂 14 統計方法 16 第三章 實驗結果 17 第一節 髁盤關係 17 第二節 骨質密度 17 第三節 身體質量指數 18 第四節 退行性顳顎關節變化 19 第五節 顱顏面型態 21 顱顏面型態不對稱 21 第六節 對數成敗比迴歸分析 22 第四章 討論 24 第一節 受測者分佈 24 第二節 骨質密度 24 第三節 身體質量指數 26 第四節 退行性顳顎關節變化 27 第五節 顱顏面型態 28 第六節 罹患關節盤不可復位性移位之篩檢指標: 29 第五章 總結 31 第六章 未來展望 32 參考文獻 67 | |
dc.language.iso | zh-TW | |
dc.title | 顳顎關節內部紊亂症其嚴重度、相關致病危險因子與顱顏面型態關係之研究 | zh_TW |
dc.title | The relationship between severity, risk factors of TMJ internal derangement and craniofacial morphology | en |
dc.type | Thesis | |
dc.date.schoolyear | 95-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 蕭裕源 | |
dc.contributor.oralexamcommittee | 許明倫,施庭芳,王若松 | |
dc.subject.keyword | 顳顎關節內部紊亂症,身體質量指數,骨質密度,顱顏面型態,篩檢指標, | zh_TW |
dc.subject.keyword | TMJ ID,BMI,BMD,craniofacial morphology,screen score, | en |
dc.relation.page | 73 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2007-07-31 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 臨床牙醫學研究所 | zh_TW |
顯示於系所單位: | 臨床牙醫學研究所 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
ntu-96-1.pdf 目前未授權公開取用 | 1.49 MB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。