关节镜下盘复位固定术联合功能矫治器治疗颞下颌关节不可复性盘前移位的临床美学观察

Clinical aesthetic observation of the arthroscopic disc repositioning and suturing technique combined with functional appliances in the management of ADDWoR of TMJ

目的:探讨关节镜下盘复位固定术联合功能矫治器对颞下颌关节(temporomandibular joint,TMJ)不可复性盘前移位(anterior disc displacement without reduction,ADDWoR)患者面容、功能的改善效果。方法:选取2018年7月—2019年12月行关节镜下盘复位固定术联合功能矫治器治疗的37例ADDWoR患者,并对其进行随访,测定患者术前与术后6个月的头影测量与磁共振成像(magnetic resonance imaging,MRI)数据,分析髁突高度、关节腔间隙宽度、E线、H角等的变化,并将其与美学标准进行对比,经过配对t检验,探讨该联合治疗对患者面容的影响。结果:37例患者经联合治疗后,髁突高度与关节腔间隙宽度均得到了一定程度的改善(P<0.001),软组织测量指标也更贴近于美学标准。结论:关节镜下盘复位固定术联合功能矫治器能改善ADDWoR患者的面容及关节症状。

Objective:To investigate the effects of the arthroscopic disc repositioning and suturing technique combined with functional appliances on the improvement of facial features and functions in patients with anterior disc displacement without reduction(ADDWoR)of temporomandibular joint(TMJ).Methods:Cephalometric and magnetic resonance imaging(MRI)data of 37 ADDWoR patients who were followed up after receiving treatment of arthroscopic disc repositioning and suturing technique combined with functional appliances were collected before the operation and 6 months after the treatment from July 2018 to December 2019.The condylar height,the width of joint cavity,E-line,H-angle and other data were measured.These data were compared with the aesthetic standard,and verified by paired t test to investigate the effect of the combined treatment on patients′facial appearance.Results:After the treatment,the condylar height and the width of joint cavity were improved(P<0.001)and the soft tissue cephalometric indexes became closer to the aesthetic standard.Conclusion:The arthroscopic disc repositioning and suturing technique combined with functional appliance can ameliorate the patients′abnormal face contour,especially indicated to ADDWoR.