턱얼굴 외상이 턱관절에 미치는 영향 평가:임상 및 핵의학적 평가

Abstract

Purpose: This study compared the conformity of three diagnotic tools (panoramic view, temporomandibular (TM)-panoramic view, and bone scan) with the clinical symptoms and analyzed the efficiency of bone scan as a diagnotic tool. Materials and Methods: This study included 28 patients (9 males, 19 females) who had facial trauma (mandible fracture, maxilla fracture) before comming at Seoul National University Bundang Hospital from September, 2003 to October, 2013. They were examed by dental panoramic view, TM-panoramic view and technetium 99m pyrophosphate bone scan. Then we compared the values of the hot spots, the impressions of panoramic view and TM panoramic view with clinical symptoms. The patients were divided with two groups. Group A was composed by the patients who had traumas in the temporomandibular joints (TMJs) without fractures, and Group B was by those with fractures. Results: The clinical symptoms related with temporomandibular disorder (TMD) were pain in the TMJs, crepitus, trismus, and malocclusion. The symptomatic TMJs were 32 cases (57.14%) and symptomless TMJs were 24 cases (42.86%) in the total 56 TMJs. The three diagnotic tools (panoramic view: 56.25%, TM-panoramic view: 53.13%, and bone scan: 56.25%) had similar confirmity with clinical symptoms. The conformity of bone scan with clinical symptoms was the most in Group B (the patients who had trauma in the TMJs with fractures) especially. Conclusion: Bone scan has similar clinical efficiency with panoramic view and TM-panoramic view when it is used at diagnosis of TMD after maxillofacial trauma, especially at the case of the patients with fractures.