牙合垫治疗阻生牙伴颞下颌关节紊乱病的临床研究

Clinical study on soft plastic maxillary pad in treatment of impacted tooth with temporomandibular disorders

目的:探讨阻生牙伴颞下颌关节紊乱患者应用牙合垫治疗的临床效果。方法:选取36例伴阻生牙颞下颌关节紊乱病的的患者,由同一医师评估患者双侧颞下颌关节功能,制作2mm上颌软牙合垫并戴入,佩戴2周、1个月、2个月、3个月时复诊,评价患者颞下颌关节功能,计算治疗功能障碍指数(DI)、肌肉压痛指数(PI)和颅颌指数(CMI),评价牙合垫对阻生牙伴颞下颌关节功能恢复的影响。结果:治疗2周后,患者疼痛及下颌运动障碍症状改善,弹响症状改善在戴用牙合垫1个月后明显缓解。随着治疗时间延长,患者DI指数、PI指数、CMI指数逐渐降低,治疗2周后患者DI指数(0.138±0.024Vs0.379±0.055)、PI指数(0.017±0.002Vs0.025±0.004)即较治疗前显著下降(P<0.05),治疗1、2、3月后均较治疗前进一步降低(P<0.05);CMI指数在治疗2周后与治疗前未见显著性差异,治疗1月后CMI指标较治疗前显著降低(0.053±0.006 Vs.0.105±0.018)(P<0.05),治疗2个月、3个月后CMI指数均较治疗前显著降低(P<0.05)。结论:对阻生牙伴下颌关节紊乱病的青壮年患者采用上颌牙合垫治疗可显著改善颌关节功能,具备临床推广意义。

Objective To investigate clinical efficacy of soft plastic maxillary pad in treatment of impacted tooth with temporomandibular disorders. Methods 36 patients with impacted teeth and temporomandibular disorder were selected as study objects,and bilateral temporomandibular joint function was accessed by the same, and 2mm maxillary soft pad was made and applied,after wearing for 2 weeks,lmonth,2month,3month,temporomandibular joint function was evaluated,and dysfunction index（DI）,palpation index（PI）and craniomandibularlndex（CMI）were calculated to evaluate the influence of maxillary pad on functional recovery of patients with impacted tooth and temporomandibular disorders. Results After 2 weeks treatment, symptoms of pain and mandibular movement disorder significantly alleviated,snapping symptoms obviously improved after 1 month treatment.With time prolonged,DI index,PI index,CMI index decreased gradually,after 2 weeks of treatment DI index（0.138 ± 0.024 Vs.0.379 ± 0.055）,PI index（0.017 ± 0.002 Vs.0.025 ± 0.004）significantly decreased compared with pretreatment（P〈0.05）,after treatment for 1month, 2month,3month DI index, PI index made a further reduction （P〈0.05）;the CMI index in 2 weeks after treatment with no significant improvement,and after 1month treatment CMI index was significantly reduced comparedwith pretreatment（0.053 ±0.006 Vs.0.105 ± 0.018） （P〈0.05）,CMI index after treatment for 2 month, 3month with a further reduction （P〈0.05）. Conclusion The impacted tooth with temporomandibular disorders with maxillary pad treatment can significantly improve the temporomandibular joint function, has significance of clinical promotion.