分期治疗方案矫治成人颞下颌关节强直及其继发畸形

Two-stage treatment protocol for the management of temporomandibular joint ankylosis with secondary deformities in adults

目的:总结作者用分期治疗方案矫治成人颞下颌关节强直及其继发畸形的经验。方法:对24例30侧关节实施了分期治疗方案,通过一期手术解除颞下颌关节强直,正畸治疗结束后行二期手术矫正继发颌骨畸形。通过对患者手术前后的颜面外形、张口度和影像学检查进行对比以评估临床疗效。结果:所有患者均成功实施了分期治疗方案,与术前相比,患者的颜面畸形以及咬合情况均得到了显著改善,平均张口度由3.4 mm增加到32.5 mm(P<0.05)。结论:分期治疗能有效矫治成人颞下颌关节强直及其继发畸形。

Objective：To introduce a 2-stage treatment protocol for the management of temporomandibular joint ankylosis with sec-ondary deformities in adults.Methods：24 adult patients （9 males and 15 female）（30 joints）at the average age of 26.1 years un-derwent TMJ reconstruction as the initial surgery,followed by orthodontic treatment and correction of secondary deformities as the sec-ond surgery.Clinical outcome was assessed based on maximal incisal opening,radiography and medical photography.Results：Skele-tal deformities were significantly improved in all patients,satisfactory occlusion was achieved with the orthodontic treatment,average maximal incisal opening increased from 3.4 mm to 32.5 mm（P 〈0.05）.Conclusion：The 2-stage treatment protocol is an effective approach for management of TMJ ankylosis with secondary deformities in adult patients.