颞下颌关节盘不可复前移位锚固术后临床疗效评估

Evaluation of clinical efficacy after temporomandibular joint disc irreversible anterior displacement anchorage

目的评估颞下颌关节盘不可复前移位锚固术后临床疗效。方法选取2019年10月至2022年6月收治于上饶市人民医院的80例颞下颌盘不可复前移位患者作为研究对象,按不同手术方式将其分为对照组和观察组,各40例。对照组采用传统前伸再定位咬合板治疗,观察组采用颞下颌关节盘锚固术。比较两组术前及术后1、3、6个月疼痛值、开口度、颞下颌关节功能障碍指数(DI)和紊乱指数(CMI)。结果观察组术后6个月的关节盘复位总有效率高于对照组,差异有统计学意义(P<0.05);两组的髁突骨质变化比较,差异无统计学意义(P>0.05)。两组术前开口度比较,差异无统计学意义(P>0.05);观察组术后开口度均大于对照组,差异有统计学意义(P<0.05);两组术后开口度均大于术前,差异有统计学意义(P<0.05)。两组术前视觉模拟评分法(VAS)、DI及CMI评分比较,差异均无统计学意义(P>0.05);观察组术后VAS、DI及CMI评分均低于对照组,差异有统计学意义(P<0.05);两组术后VAS、DI及CMI评分均低于术前,差异有统计学意义(P<0.05)。结论颞下颌关节盘不可复前移位锚固术能有效复位前移的关节盘,缓解疼痛,改善开口度。

Objective To evaluate the clinical efficacy of temporomandibular joint disc anterior displacement after anchorage.Methods A total of 80 patients with irreversible anterior displacement of temporomandibular disc admitted to Shangrao People's Hospital from October 2019 to June 2022 were selected as the research objects and divided into control group and observation group according to different surgical methods,with 40 cases in each group.The control group was treated with traditional forward positioning occlusal plate,and the observation group was treated with temporomandibular joint disc anchorage.The pain value,mouth opening,temporomandibular joint dysfunction index(DI)and disorder index(CMI)were compared between the two groups before operation and 1,3 and 6 months after operation.Results The total effective rate of articular disc reduction in the observation group was higher than that in the control group at 6 months after operation,and the difference was statistically significant(P<0.05).The postoperative opening degree of the observation group was greater than that of the control group,and the difference was statistically significant(P<0.05).The postoperative opening degree of the two groups was greater than that before the operation,and the difference was statistically significant(P<0.05).There was no significant difference in preoperative visual analogue scale(VAS),DI and CMI scores between the two groups(P>0.05).The postoperative VAS,DI and CMI scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The postoperative VAS,DI and CMI scores of the two groups were lower than those before operation,and the differences were statistically significant(P<0.05).Conclusion Anchorage of anterior displacement of temporomandibular joint disc can effectively restore the anterior displacement of the joint disc,relieve pain and improve the opening degree.