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例1 女,26岁,两年前张口受限,经理疗、针灸好转。近半年来张口受限伴弹响,以右侧为著,影响进食及咀嚼。检查:张口不足两横指,(?)反(牙合)、前牙闭锁(牙合),Ⅱ°深复(牙合)。(?)唇向位,(?)拥挤、触诊:右侧颞颌关节活动度极小。双侧薛瓦氏位片示:双侧颞颌关节腔后间隙增宽。左侧张口位时髁突可滑至结节前下方;右侧髁突前斜面模糊,张闭口髁突均在关节凹内。诊断:颞下颌关节功能紊乱((?)反(牙合)、前牙闭锁(牙合))。 治疗经过:(?)拔除半月,关节症状好转,张口两横指。一月后戴上活动矫正器,(?)舌簧唇向开展。两月后关节症状基本缓解,张口近三横指、弹响减轻、咀嚼较前明显好转,可嚼花生米。拔(?)、排齐(?)、同时(?)也易于唇向开展,增大前牙覆盖。半年后复诊:(?)后移已入牙列,(?)剩余1.5mm间隙,前牙覆盖正常,保持。一年后照片复查:左侧张门位:髁突向前滑动增大,稍超过上颌关节。右侧:张口时髁突可滑至上颌结节处。双侧颞颌关节腔前后间隙基本正常。
Example 1 Female, 26 years old, restricted mouth two years ago, the manager of treatment, acupuncture improved. In the past six months, the mouth was restricted with snapping ring, taking the right side as its influence on eating and chewing. Check: mouth less than two horizontal fingers, (?) Anti (occlusal), anterior teeth occlusion (occlusion), Ⅱ ° deep complex (occlusion). (?) Lip to the bit, (?) Crowded, palpation: right temporomandibular joint activity is minimal. Hirschschevier flaps showed bilateral widening of the space behind the temporomandibular joint. The left side of the mouth when the condyle can slide down to the front of the nodule; the right condylar front beveled fuzzy, open and closed condyles are in the joint concave. Diagnosis: Temporomandibular joint dysfunction ((?) Anti (occlusion), anterior teeth occlusion (occlusion)). After treatment: (?) Removal of half a month, joint symptoms improved, mouth two cross means. After January wear activity braces, (?) Reed lips to carry out. Two months after the basic relief of joint symptoms, mouth nearly three horizontal fingers, snapping to reduce chewing obvious improvement over the previous chewing peanuts. Pull (?), Aligned (?), At the same time (?) Is also easy to lip to increase the anterior tooth coverage. After six months referral: (?) After the move has been inserted into the dentition, (?) The remaining 1.5mm gap, the anterior teeth covered normal, maintained. A year after the photo review: Zhang Zhang left position: forward sliding condyle increased slightly over the maxillary joint. Right: when the mouth condyle can slide to the maxillary nodules. Bilateral temporomandibular joint space before and after the gap was normal.