Degenerative Disorders of the Temporomandibular Joint: Etiology, Diagnosis, and Treatment

病因学 颞下颌关节 医学 颞颚关节功能障碍 退行性疾病 骨关节炎 病态的 关节病 病理 口腔正畸科 疾病 替代医学
作者
Eiji Tanaka,Michael S. Detamore,Louis G. Mercuri
出处
期刊:Journal of Dental Research [SAGE Publishing]
卷期号:87 (4): 296-307 被引量:850
标识
DOI:10.1177/154405910808700406
摘要

Temporomandibular joint (TMJ) disorders have complex and sometimes controversial etiologies. Also, under similar circumstances, one person’s TMJ may appear to deteriorate, while another’s does not. However, once degenerative changes start in the TMJ, this pathology can be crippling, leading to a variety of morphological and functional deformities. Primarily, TMJ disorders have a non-inflammatory origin. The pathological process is characterized by deterioration and abrasion of articular cartilage and local thickening. These changes are accompanied by the superimposition of secondary inflammatory changes. Therefore, appreciating the pathophysiology of the TMJ degenerative disorders is important to an understanding of the etiology, diagnosis, and treatment of internal derangement and osteoarthrosis of the TMJ. The degenerative changes in the TMJ are believed to result from dysfunctional remodeling, due to a decreased host-adaptive capacity of the articulating surfaces and/or functional overloading of the joint that exceeds the normal adaptive capacity. This paper reviews etiologies that involve biomechanical and biochemical factors associated with functional overloading of the joint and the clinical, radiographic, and biochemical findings important in the diagnosis of TMJ-osteoarthrosis. In addition, non-invasive and invasive modalities utilized in TMJ-osteoarthrosis management, and the possibility of tissue engineering, are discussed.
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