下颌第三磨牙前倾阻生对TMJ慢性疼痛影响的临床观察

The effect of occlusal adjustment on TMD patients with chronic orofacial pain

目的探讨下颌第三磨牙前倾阻生与TMJ慢性疼痛的相关性。方法选择牙列完整、双侧下颌第三磨牙前倾阻生、临床表现为颞下颌关节区慢性疼痛的患者共50例,随机分为A、B两组,每组各25例。A组为实验组,所有患者均行下颌前倾阻生第三磨牙拔除术;B组为对照组,所有患者行保守治疗(理疗+口服药物),于治疗后1个月复诊,观察两组患者的治疗效果。结果①自我评价:患者依据治疗前后的主观感受进行自我评价,A组有效23例,B组有效6例,两组比较差别有统计学意义(P<0.05)。②A、B两组治疗前后VAS疼痛指数变化:A组治疗后1个月较治疗前VAS疼痛指数下降,差别有统计学意义(P<0.05);B组治疗后1个月较治疗前VAS疼痛指数下降,差别无统计学意义(P>0.05)。结论拔除前倾阻生的下颌第三磨牙对TMJ疼痛的缓解有一定的效果;对于伴有第三磨牙前倾阻生的TMJ患者,单纯的保守治疗疼痛缓解效果不佳。

Objective： To investigate the effects of mesioangular impaction of the mandibular third molars on temporomandibular disorders（TMD）patients with chronic Orofacial pain.Methods： Fifty patients were included in the study,with regular dentition and mesioangular impaction of the mandibular third molars,without impacted molar,suffering from TMJ synovitis,were randomly divided into two groups,with 25 patients in each group.The treatment group A were treated with impaction of the mandibular third molars surgical extraction,while the control group B were treated with conservative therapy for physiotherapy and oral drug.Results：① In the Self assessment of pain,after 1 month of treatment,twenty-three patients of the Group A turned better or the pain disappeared completely,and six patients of Group B turned better or the pain disappeared completely.The effective rate of the Group A was lower than that of the Group B（P0.05）.② VAS pain index of the Group A declined one month after treatment,and the difference was statistically significant;VAS pain index Of the Group B declined one month after treatment,but the difference was not statistically significant（P0.05）.Conclusion： Impaction of the mandibular third molars surgical extraction is effective in alleviating the chronic orofacial pain of TMD patients while conservative therapy was not so effective.