关节镜手术联合功能矫治器治疗颞下颌关节盘前移位的疗效评估

无忧 童, 一鸣 方

摘要


目的：对比关节镜盘复位固定术联合功能矫治器治疗与单纯功能矫治器治疗对颞下颌关节（temporomandibular joint，TMJ）不可复性盘前移位（Anterior disc displacement without reduction，ADDWoR）患者的疗效，从而探讨联合治疗的意义。方法：以经 MRI 检查诊断为颞下颌关节不可复性盘前移位的 96 例患者作为研究对象，根据患者意愿进行分组，分为关节镜手术联合功能矫治器治疗组 71 例和单纯功能矫治器治疗组 25 例，治疗前和治疗后 6 个月分别进行临床检查和 MRI 检查，对比两组的疗效。结果：治疗后，两组患者的张口度、弹响情况、疼痛度 VAS 均有改善（P ＜ 0.05），MRI 显示关节镜手术联合功能矫治器治疗组患者的关节盘均复位至正常位置；而单纯功能矫治器组患者的关节盘仍处于前移位。结论：关节镜手术联合功能矫治器对 ADDWoR 的疗效优于单纯功能矫治器，可作为治疗 ADDWoR 的重要选择。

关键词


关节镜手术；功能矫治器；颞下颌关节盘前移位；磁共振

全文:

PDF

参考


Sato F, Lima C, Tralli G, et al. Is there a correlation between arthroscopic findings and the clinical signs and symptoms of patients with internal derangement of the temporomandibular joint? A prospective study[J]. International journal of oral and maxillofacial surgery,2019,48(2):233.

Schellhas K, Pollei S, Wilkes C. Pediatric internal derangements of the temporomandibular joint: effect on facial development[J].

Miernik M, Więckiewicz W. The basic conservative treatment of temporomandibular joint anterior disc displacement without reduction—review[J]. Advances in clinical and experimental medicine: official organ Wroclaw Medical University,2015,24(4):731.

Zhang S, Liu X, Yang C, et al. New arthroscopic disc repositioning and suturing technique for treating internal derangement of the temporomandibular joint: part II—magnetic resonance imaging evaluation[J]. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons,2010,68(8):1813.

Abboud W, Nadel S, Yarom N, et al. Arthroscopy of the temporomandibular joint for the treatment of chronic closed lock[J]. The Israel Medical Association journal: IMAJ,2016,18(7):397-400.

Fujarra F, Kaziyama H, Siqueira S, et al. Temporomandibular disorders in fibromyalgia patients: are there different pain onset?[J]. Arquivos de neuro-psiquiatria,2016,74(3):195-200.

Israel H. Technique for placement of a discal traction suture during temporomandibular joint arthroscopy[J]. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons,1989,47(3):311.

Tarro, Allen W. Arthroscopic treatment of anterior disc displacement: A preliminary report[J]. Journal of Oral & Maxillofacial Surgery Official Journal of the American Association of Oral & Maxillofacial Surgeons,1989,47(4):353.

Eberhard D, Bantleon H, Steger W. The efficacy of anterior repositioning splint therapy studied by magnetic resonance imaging[J]. European journal of orthodontics,2002,24(4):343-352.

Ruf S, Wüsten B, Pancherz H. Temporomandibular joint effects of activator treatment: a prospective longitudinal magnetic resonance imaging and clinical study[J]. The Angle orthodontist,2002,72(6):527-540.

Ferrario V, Sforza C, Tartaglia G, et al. Immediate effect of a stabilization splint on masticatory muscle activity in temporomandibular disorder patients[J]. Journal of oral rehabilitation,2002,29(9):810.

Wolford L, Cardenas L. Idiopathic condylar resorption: diagnosis, treatment protocol, and outcomes[J]. American journal of orthodontics and dentofacial orthopedics:official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics,1999,116(6):667-677.




DOI: https://doi.org/10.12346/pmr.v4i1.5429

Refbacks

  • 当前没有refback。