口腔病理科
On-Line KMU Student Bulletin
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原文題目(出處)： Prevalence of whiplash trauma in TMD patients: a systematic review. J Oral Rehabil 2014;41: 59-68
原文作者姓名： Haggman-Henrikson B
通訊作者學校： Department of Odontology/Clinical Oral Physiology, Ume a University
報告者姓名(組別)： 魏祥禮 Intern J 組
報告日期： 103/05/06
內文：
Introduction:
A. Whiplash: hyperextension trauma to the neck
Whiplash-associated disorders(WADs): most common symptoms headaches and neck pain
Neck pain is often also reported in patients with TMD pain Materials and methods:
A. Inclusion :clinical studies adult patients, history of whiplash trauma in a TMD population
B. Literature search: PubMed, the Cochrane Library, and Bandolier, 1996~2012 C. Procedure: BH and MR independently read all titles and abstracts to identify
potentially eligible articles for inclusion
D. Quality assessment: BH and TL, evaluated the quality of the included studies using a scoring system with a standardised 21-item; only scored “yes” can get score
Results:
A. three databases + hand search ->129 articles B. initial screening of abstracts ->32 articles (left)
C. reviewed in full text ->6 articles left (26 articles were excluded) reasons: a. not based on TMD populations (62%)
b. not report original data (27%)
c. not define TMD/trauma groups (11%)
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D. Compared TMD patients: with V.S. without a history of neck injury
->more TMD pain, more severe jaw dysfunction, and more headaches, stress, dizziness,and sleeping problems
Discussion:
A. prevalence of whiplash trauma: TMD > non-TMD ->neck trauma is a comorbid condition for TMD
B. more TMD pain and more severe jaw dysfunction: with > without whiplash trauma history
-> poorer prognosis for recovery, and seek and demand more treatment
-> TMD after whiplash trauma has a different pathophysiology compared with localized TMD
C. most studies in acute whiplash patients report a lower prevalence of TMD pain
-> TMD after a whiplash trauma may develop over time, rather than acute syndrome
D. WAD(Whiplash-associated disorders) patient:
a. acute whiplash injury will recover,
b. long-term symptoms with greater initial pain and disability
-> lowered sensory and pain thresholds due to central sensation -> pain and dysfunction in the jaw region easier
E. etiology for TMD is multifactorial, further studies on the mechanisms of the
口腔病理科
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association between whiplash trauma and TMD is needed
Conclusions:
A. prevalence of whiplash trauma is higher in patients with TMD compared with controls
B. TMD patients with comorbid TMD/whiplash have more jaw pain and more severe jaw dysfunction
-> whiplash trauma might be an initiating and/or aggravating factor as well as a comorbid condition for TMD
(對於 TMD 可能是起始因素 或是加重嚴重度的因素) 題號 題目
1 Which of the underlying concepts for maintaining the prominence of TMJ is
“wrong”?
(A) There is only one stationary axis of condylar rotation during the initial stage of assisted opening and closing
(B) The defined reference position of the mandible is fixed in relation to the cranium throughout life
(C) This position coincides with the centric occlusion(CO) position of the condyle
(D) This axis of rotation is readily transferable to an artriculator 答 案
(C)
出處：
Temporomandibular disorders : an evidence-based approach to diagnosis and treatment P.35~36
-> This position coincides with the centric relation(CR) position of the condyle
題號 題目
2 One of the most intriguing( 奇 妙 的 ) questions has been the specific relationship amount the following things while the mandible is in its CR position .
(A) Condyle head (B) Articular disc (C) Articular fossa (D) Mandible body 答 案
(D)
出處：
Temporomandibular disorders : an evidence-based approach to diagnosis and treatment P.41
