3D打印咬合板治疗不可复性颞下颌关节盘前移位的临床评价

Clinical evaluation of 3D printed splint in the treatment of anterior disc displacement without reduction

目的:通过对比3D打印与传统稳定性咬合板治疗不可复性颞下颌关节盘前移位的临床疗效,初探3D打印咬合板在临床上治疗颞下颌关节盘移位等颞下颌关节病的可行性。方法:选取自2018年1月至2019年1月在解放军总医院第一医学中心口腔科就诊的患者60例,经临床检查、锥形束CT及MRI检查确诊为不可复性颞下颌关节盘前移位患者随机分为2组,传统咬合板治疗组30例,3D打印咬合板治疗组30例。传统咬合板组采用传统工艺进行制作,3D打印咬合板组采用个性化设计,3D打印技术制作。对比两组义齿制作的复杂程度、患者佩戴咬合板时舒适、美观满意度情况。记录患者治疗前,治疗1个月、3个月开口度和颞颌关节疼痛指数的变化,采用SPSS25.0软件对结果进行统计学分析。结果:组内比较:两组治疗后1个月、3个月开口度和颞颌关节疼痛指数均较治疗前差异显著(P<0.01);组间比较:治疗前,治疗后1个月、3个月两组患者开口度和颞颌关节疼痛指数均无统计学差异(P>0.05)。3D打印咬合板的制作程序比稳定性咬合板更简单;3D打印咬合板舒适和美观满意度高于稳定性咬合板(P<0.05)。结论:3D打印咬合板治疗不可复性颞下颌关节盘前移位的治疗效果与传统咬合板无差异,而且比传统咬合板治疗程序更简单,美学、舒适效果更佳。

Objective:To compare the effect of three-dimensional(3D)printed splint with traditional splint in the treatment of anterior disc displacement without reduction(ADDwoR),and to explore the feasibility of 3D printed splint in the treatment of disc displacement and other temporomandibular joint diseases.Methods:60 patients with ADDwoR diagnosed by clinical examination,cone-beam CT and MRI from January 2018 to January 2019 were randomly divided into two groups:traditional splint group(30 cases)and 3D printed splint group(30 cases).conventional stabilization splint group is made by traditional technology,3D printed splint group is made by personalized design and 3D printed technology.Compare the comfort and aesthetic satisfaction of patients wearing splint between the two groups.Before,1 and 3 months after treatment,the changes of maximal mouth opening and temporomandibular joint pain index were recorded,and the results were analyzed by SPSS25.0 software.Results:The comfort and aesthetic satisfaction of 3D printed splint was higher than that of traditional splint(P<0.05);intra-group comparison:There were significant differences in opening degree and temporomandibular joint pain index between the two groups at 1 and 3 months after treatment(P<0.01).Inter-group comparison:There was no significant difference in the opening degree and temporomandibular joint pain index between the two groups before,1 and 3 months after treatment(P>0.05).Conclusion:There is no difference between 3D printed splint and conventional splint in the treatment effect of ADDwoR,and the procedure of 3D printed splint is simpler and the aesthetic and comfortable effect is better than that of conventional stabilization splint.