关节下腔治疗颞下颌关节不可复性盘前移位

Lower joint cavity treatment of temporomandibular joint with anterior disc displacement without reduction

目的研究经关节下腔治疗颞下颌关节(TMJ)不可复性盘前移位(ADDw/oR)的临床疗效。方法将临床和影像学检查确诊的单侧TMJADDw/oR患者56例,随机分为关节上腔组和下腔组,以治疗前作对照,经关节内灌洗、注射玻璃酸钠后行手法复位并佩戴密歇根(Michigan)稳定性咬合板2个月,复诊记录摩擦指数并评价其疗效。结果关节上腔和下腔治疗组开口度均较治疗前明显增大(P<0.01),摩擦指数值较治疗前均明显下降(P<0.01);下腔治疗组开口改善度较上腔治疗组增加明显(P<0.05),而摩擦指数值又明显小于上腔治疗组(P<0.05)。结论TMJADDw/oR的关节下腔治疗效果明显优于上腔。

Objective To study the clinical effects of the lower joint cavity treatment on the patients with anterior disc displacement without reduction（ADDw/oR） of temporomandibular join（tTMJ）.Methods 56 patients with ADDw/oR were randomly divided into two groups：The upper joint cavity treatment group and the lower joint cavity treatment group.Manual reduction was used on all the patients after intra-articular injection of hyaluronate.And then,they were treated with the Michigan stabilization splint.At last,friction index values were recorded and used to evaluate the curative effect.Results The maximal mouth-opening degrees in the upper and lower joint cavity treatment groups increased more significantly than those in pre-treatmen（tP0.01）,and friction index values decreased more significantly than those before treatment（P0.01）.In the lower joint cavity treatment group,the improving degrees of maximal mouth-opening increased more significantly than those in upper joint cavity treatment group（P0.05）,and friction index values were also obviously lower than those in upper joint cavity treatment group（P0.05）.Conclusion On the patients with ADDw/oR,the clinical effects of the lower joint cavitytreat-ment are superior to those of the upper joint cavity treatment.