手法复位加咬合板治疗急性颞下颌关节盘不可复性前移

Treatmentof manualreduction followed by repositioning splint for acute anterior TMJ disk displacement without reduction

目的:探讨手法复位加再定位咬合板治疗对急性颞下颌关节盘不可复性前移位的治疗效果。方法:选取46名急性关节盘不可复性前移位患者行手法复位后分成两组,A组佩戴再定位咬合板,B组不作处理。3个月后对所有患者的疼痛程度和最大主动张口度进行评价,采用SPSS21. 0软件包对数据进行t检验。结果:46例患者最大主动张口度均明显改善,A组、B组患者由治疗前的(20. 6±1. 9)mm、(19. 7±2. 5)mm增加到(41. 9±3. 6)mm和(37. 6±5. 3)mm;两组患者疼痛均明显缓解,VAS分别由治疗前(6. 7±0. 9、5. 9±1. 2)下降到(1. 8±0. 8、2. 5±0. 7)。治疗3个月后A组、B组最大主动张口口度以及VAS评分的比较,差异有统计学意义。结论:手法复位加再定位咬合板能较好地恢复盘-髁关系,并能缓解肌源性和关节源性疼痛。

Objective: To explore the clinical effect of manual reduction combined with repositioning splint treatment of acute anterior TMJ disc displacement without reduction (ADDWR). Methods: Forty-six patients diagnosed as acute ADDWR by CBCTwere divided into 2 groups after manual reduction. Group A were combined with anterior repositioning splint treatment, while group B with no other treament. 3 monthslater, the maximum active mouth opening and visual analogue scale (VAS) score of TMJ pain were assessed. SPSS 21.0 software package was used for t-test. Results: The maximum active mouth opening of group A and B increased from (20.6±1.9)mm and (19.7±2.5)mm to (41.9±3.6)mm and (37.6±5.3)mm, VAS score of pain decreased from(6.7±0.9、5.9±1.2) to (1.8±0.8、2.5±0.7). Aftertherapy, the maximum active mouth openingand VAS score showed statistical significance (P<0.001) between 2 groups. Conclusions: Manual reduction combined with anterior repositioning splint treatment can help to maintain better anatomic disc-condyle relationship and alleviate the pain from muscle and joint.