体外电磁式冲击波和再定位咬合板治疗颞下颌关节可复性盘前移位的临床疗效

Comparison of the clinical efficacy of extracorporeal electromagnetic shock wave and anterior repositioning splint on anterior disc displacement with reduction

目的:比较体外电磁式冲击波和再定位咬合板治疗颞下颌关节可复性盘前移位的临床疗效。方法:回顾分析2021年3月至2023年1月在皖南医学院第一附属医院弋矶山医院口腔颌面外科诊治的51例颞下颌关节可复性盘前移位患者,根据治疗方法不同分为体外电磁式冲击波治疗组28例和再定位咬合板组23例,两组均连续治疗3个月。采用视觉模拟疼痛评分(visual analogue scale,VAS)、张口度、颞下颌关节功能障碍指数DI值(dysfunction index,DI)和生活质量SF-36评分(short form 36 questionnaire,SF-36)比较两种治疗方法的治疗效果。结果:两组治疗前,VAS评分、张口度、DI值以及生活质量SF-36评分的比较,差异无统计学意义(P>0.05);经过治疗,体外电磁式冲击波治疗组VAS评分低于再定位咬合板治疗组(P<0.05);再定位咬合板治疗组DI值低于体外电磁式冲击波治疗组(P<0.05);两组在张口度和生活质量SF-36评分上差异无统计学意义(P>0.05)。结论:在关节疼痛方面,体外电磁式冲击波治疗效果好;在颞下颌关节临床障碍方面,再定位咬合板治疗效果好,两种方法在治疗张口度和生活质量SF-36评分上无明显区别。

Objective:To compare the clinical effect of extracorporeal electromagnetic shock wave and anterior repositioning splint on anterior disc displacement with reduction.Methods:A total of 51 patients with anterior disc displacement with reduction that were treated in the Oral and Maxillofacial Surgery Department of Yijishan Hospital,the First Affiliated Hospital of Wannan Medical College from March 2021 to January 2023 were retrospectively analyzed.The patients were divided into the extracorporeal electromagnetic shock wave therapy group 28 cases and the anterior repositioning splint group,with 23 cases in each group.Both groups were treated for 3 months.The visual analogue scale(VAS)score,degree of mouth opening,temporomandibular joint dysfunction index(DI)value,and SF-36 score on quality of life of the two groups were analyzed to compare the clinical efficacy of the two different treatment methods.Results:The differences in VAS score,degree of mouth opening,DI value,and SF-36 score on quality of life between the two groups before the treatment was not statistically significant(P>0.05).After treatment,the VAS score of the extracorporeal electromagnetic shock wave therapy group was lower than the anterior repositioning splint group,and the difference was statistically significant(P<0.05).The anterior repositioning splint group have a lower DI value than the extracorporeal electromagnetic shock wave therapy group,and the difference was statistically significant(P<0.05).Conclusion:The extracorporeal electromagnetic shock wave therapy is better at treating joint pain.The anterior repositioning splint is better in the treatment of TMJ dysfunction.There is no significant difference between the two methods in improving the degree of mouth opening and SF-36 score on quality of life.