大学课件25 颞颌关节强直

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1、TreatmentofAnkylosisofTemporomandibularJointDefinition:intra-articularandextra-articularprocessesmayrestrictjawmotionseverely.AnkylosisoftheTMJisanintra-articularprocesscharacterizedbyfibrous,fibro-osseous,orosseousobliteration(消失)ofthejointspace.Extracapsul

2、arcausesofrestrictedjawmotion(pseudoankylosis)includebutarenotlimitedtocoronoid-zygomaticfusion(融合),coronoidhypertropy,andmuscularfibrosis.1Indicationsfortherapyforankylosis(mayincludeoneormoreofthefollowing)Severelyrestrictedjawmotionaccompaniedbyoneormoreo

3、fthefollowing:InadequatemasticatoryfunctionAbnormalspeechInabilitytoundergodentaland/ormedicalcareCompromisedanestheticmanagementInhibitedfacialgrowthImagingevidenceofosseousorsofttissueabnormality2PresenceofageneraltherapeuticgoalB.ReleaseofankylosisC.Acces

4、sfordentaland/ormedicalcareD.ImprovedspeechE.ImprovedmasticatoryfunctionF.RelieforreductionofpainSpecificTherapeuticGoalsforAnkylosis(Thegoaloftherapyistorestoreformand/orfunction.However,riskfactorsandpotentialcomplicationsmaypreclude(妨碍)completerestoration

5、offormand/orfunction)3SpecificFactorAffectingRiskforAnkylosis(Severityfactorsthatincreaseriskandthepotentialforknowncomplications)PresenceofageneralfactoreffectingriskTypeofankylosis(ie,fibrousorbony)C.Etiologyoftheankylosis(eg,traumaticorinflammatory)D.Exte

6、ntanddurationofankylosisE.Degreeofpre-existingmuscularatrophyF.Ankylosisinagrowingchild4IndicatedtherapeuticstandardsforankylosisGeneralhistoryandphysicalexaminationFocusedhistoryandphysicalexaminationoftheTMJregiontoregiontodeterminethepresenceofindication

7、sforcareofankylosisandtoidentifyfactorsaffectingrisksAnimagingexamination,ifindicated,basedonthehistoryandphysicalfindings.Theexaminationmayincludebutisnotlimitedto:panoramicradiograph,cephalometricradiograph,conventionaltomogram,CTscan,and/orMRIThepretre

8、atmentassessmentincludes:5Post-treatmentmanagementWoundcarePainmanagementDietandoralhygiene(卫生)managementOcclusalmanagementPhysicaltherapyAppropriatediagnosticrecordstodetermineprogressionofthe