单纯透明质酸注射治疗对颞下颌关节功能和结构的影响

Influences on TMJ Structure and Function by Injection with Hyaluronic Acid

目的：利用MRI评价颞下颌关节功能和结构在透明质酸治疗前后的变化。方法：选取经过颞下颌关节门诊治疗的TMJ结构紊乱患者23例行单纯关节上腔透明质酸钠注射治疗。23例患者中,男性3例,女性20例,年龄16~58岁,平均年龄27.8岁。利用MMO及VAS评价患者颞下颌关节功能治疗前后的变化;并对所有患者进行治疗后颞下颌关节MRI检查,评价颞下颌关节结构变化。结果：23例经HA治疗的患者,治疗前MMO 25.90、VAS5.78。治疗后MMO 35.12、VAS1.42,经统计学处理,有统计学意义（P〈0.05）。MRI检查显示治疗后23例患者中均未发现颞下颌关节盘复位。结论：单纯经关节上腔注射HA治疗颞下颌关节结构紊乱可有效改善患者功能,但对颞下颌关节结构无明显影响。

Objective： To evaluate the position and the function of temporomandibular joint（TMJ） articular discs by joint space injection with hyaluronic Acid（HA）. Methods： 23 patients with unilateral TMJ internal derangement （ID） （23TMJs） were selected between 2009 and 2013, at the Department of Oral and Maxillofacial Surgery, Suzhou municipal Hospital. All patients were subjected to magnetic resonance imaging（MRI） 3-6 months after joint space injection with HA to determine the disc position of TMJ. Results： The maximal mouth opening（MMO） and visual analogue score（VAS） of each patient had statistical significant difference before and after HA injection （P〈0.05）. MMO of 23 patients： 25.90 before HA injection, 35.12 after HA injection. VAS of patients： 5.78 before treatment, 1.42 after treatment. The position of TMJ articular discs remained unchanged by MRI after HA injection. Conclusion： This study showed that the therapeutic effect of joint space injection with HA on temporomandibular disorder（TMD） is preferable, but it has no effect on disc repositioning of TMJ confirmed by MRI.