关节上下腔注射透明质酸联合稳定性咬合板治疗颞下颌关节盘不可复前移位的对比研究

The comparsion between superior and inferior joint space injections of hyaluronic acid (HA) combined with stable biteplate in the treatment of patient with temporomandibular joint (TMJ) anterior disc displacement without reduction (ADDw/oR)

目的探讨关节上腔注射和关节下腔注射透明质酸(hyaluronic acid,HA)联合稳定性咬合板(stable biteplate,SBP)在治疗颞下颌关节盘不可复性前移位中的应用及其疗效。方法 62例颞下颌关节盘不可复性前移位患者中,4例未完成治疗,58例患者随机分为两组:A组(27例)给予关节上腔注射HA联合稳定性咬合板,B组(31例)给予关节下腔注射HA联合稳定性咬合板,比较两组患者治疗前、后最大开口位(MMO)和关节压诊(JP)指数的变化。结果 A、B组治疗3个月后较同组治疗前的最大开口位、关节压诊指数明显改善,差异有统计学意义(P<0.05)。治疗3个月后,B组最大开口位和关节压诊指数改善较A组明显,差异有统计学意义(P<0.05)。A、B组患者颞下颌关节症状及功能随着治疗次数的增加而改善。结论关节上下腔注射HA联合稳定性咬合板对于治疗颞下颌关节盘不可复性前移位均有良好的效果,关节下腔注射HA联合稳定性咬合板治疗效果优于关节上腔注射HA联合稳定性咬合板。

Objective To explore the effect of superior and inferior joint space injections of hyaluronic acid（HA）combined with stable biteplate（SBP）in therapy of patients diagnosed with temporomandibular joint（TMJ）anterior disc displacement without reduction（ADDw/oR）.Methods Sixty-two patients with ADDw/oR were randomly divided into two groups.Four cases did not complete the treatment.Group A（27cases）received superior joint space injection of HA combined with SBP,Group B（31cases）received inferior joint space injection of HA combined with SBP,MMO and JP were detected before treatment and at 3mouths after treatment.The data was processed using SPSS17.0software package.Results At 3months after treatment,In the groups A and B,MMO improved significantly compared with before treatment,and JP decreased significantly relative to before（P〈0.05）.At 3 months after treatment,group B compared with group A,MMO and JP were significantly improved.A,B two groups of patients with temporomandibular joint symptoms and function with the increase in the number of treatment to improve.Conclusion Superior and inferior joint space injections of HA combined with SBP were effective methods for the treatment of patients with ADDw/oR.The injection of HA within the inferior joint space combined with SBP has a better effect.