高频超声探测牙合板治疗颞下颌关节紊乱病效果的临床研究

Effect of High-frequency Ultrasound Detection on Treatment of Temporomandibular Joint Disorders using Repositioning Splint

目的:应用高频超声测量双侧咬肌的平均厚度及关节囊宽度,探测再定位牙合板治疗颞下颌关节紊乱病(temporomandibular joint disorders,TMD)的效果。方法:随机入选23例因颞下颌关节激发性疼痛及关节弹响就诊于我科的TMD患者作为实验组,同时选取20例健康志愿者作为对照组,实验组采用再定位牙合夹板治疗,分别在治疗前、治疗1月、2月及3月后采用实时高频超声对咬合状态及非咬合状态下双侧咬肌厚度及关节囊宽度进行客观测量,与对照组进行对比,同时记录实验组治疗前后症状的变化。结果:实验组在牙合板治疗前非咬合状态下双侧咬肌高频超声平均厚度为9.42 mm,咬合后为13.04 mm,对照组非咬合状态下双侧咬肌平均厚度为8.48 mm,咬合后为10.27 mm,两组治疗前咬合状态及非咬合状态下双侧咬肌高频超声厚度差异均有统计学意义(P<0.001),且实验组治疗后每个月咬肌厚度变化均与实验组治疗前存在统计学差异(P<0.001)。关节囊宽度在牙合板治疗前两组差异无统计学意义(P>0.05),治疗后疼痛及弹响症状明显改善,治愈率为52.2%。结论:TMD患者咬肌平均厚度增宽,关节囊宽度无明显变化,牙合板治疗后较治疗前咬肌厚度每月均明显减低,效果显著,高频超声可作为评估牙合板治疗效果的一种有效的工具,为临床诊断及评估治疗TMD的临床效果提供依据。

Objective:To investigate the effect of repositioning splint on temporomandibular disorders(TMD)by measuring the cross-sectional area of bilateral masseter muscles and the width of joint capsule by high-frequency ultrasound.Methods:Twenty-three patients with temporomandibular joint pain and joint play sound visited our department were randomly selected as the experimental group,and 20 healthy volunteers as control group.Experimental group was received positioning grind splint treatment.The thickness of bilateral masseter muscle and the width of joint capsule were measured by high-frequency ultrasound before treatment and 1,2,and 3 months after treatment,and compared with the control group.The changes of symptoms before and after treatment in the experimental group were recorded.Results:In the experimental group,the average thickness of bilateral masseter muscle was 9.42 mm in the non-occlusal state and 13.04 mm in occlusal state before treatment.In the control group,the average thickness of bilateral masseter muscle was 8.48 mm in the non-occlusal state and 10.27 mm in occlusal state.There was statistical significance between two groups before treatment(P<0.001).Additional,the masseter muscle thickness had significant difference each month after treatment in the experimental group(P<0.001).The joint capsule width in the jaw plate had no statistically significant difference between two groups before treatment(P>0.05).After treatment,the symptoms of pain and ringing were significantly improved,and the cure rate was 52.2%.Conclusion:The effect occlusal plate is significant.High-frequency ultrasound can be used as an effective tool to evaluate the treatment effect of occlusal plate,providing a basis for clinical diagnosis and evaluation of the clinical effect of TMJ disorders.