钛板植入治疗双侧颞下颌关节习惯性脱位

Surgical Treatment of Bilateral Habitual Temporomandibular Joint Dislocation Using Titanium Miniplate

目的:探讨小型钛板植入治疗双侧颞下颌关节习惯性脱位的临床疗效。方法:2008年2月～2011年6月对12位双侧颞下颌关节习惯性脱位患者采用2.0系列"Y"型钛板及长6mm钛钉植入手术治疗。对患者术前脱位频率、术前术后最大开口度(Maximal interincisor opening,MIO)、关节疼痛指数(visual analogue scale,VAS)、术后复发情况及面神经功能进行评估。结果:术后平均MIO(41.33±5.16)mm(32～48mm)较术前(47.75±5.13)mm(40～55mm)明显减小(P<0.05)。术后颞下颌关节疼痛指数VAS为0.92±0.90较术前4.08±1.78明显减低(P<0.05)。术后患者均无面神经损伤表现。2例患者随访过程中出现钛板断裂及颞下颌关节脱位复发。结论:使用钛板治疗双侧习惯性颞下颌关节脱位,能够改善关节功能,预防复发。

Objective： To explore the surgical treatment of bilateral habitual temporomandibular joint（TMJ） dislocation using designed miniplates.Methods： Twelve patients with bilateral TMJ dislocation underwent the surgical treatment from 2008 to 2011.The 2.0 series ＂Y＂ shape titanium miniplate was applied and fixed by screws with 6 mm length in the zygomatic arch and TMJ eminence.The maximal interincisor opening（MIO）,functional TMJ pain valued by visual analogue scale（VAS）,frequency of TMJ dislocation and paralysis of facial nerves were evaluated preoperatively and postoperatively.Results： All cases were followed up for 12-28 m.The average of MIO decreased significantly from 47.75±5.13 mm（40-55 mm） preoperatively to 41.33±5.16 mm（32-48 mm） postoperatively（P＆lt;0.05）.The average VAS of functional TMJ pain decreased significantly from 4.08±1.78 preoperatively to 0.92±0.90 postoperatively（P＆lt;0.05）.No facial nerve paralysis was observed among the 12 patients postoperatively.Miniplate fracture was occurred in 2 cases.There was no recurrence of TMJ dislocation in all patients.Conclusion： It suggested that the application of titanium miniplate might be an effective way in the surgical treatment of habitual TMJ dislocation.