颞下颌关节上腔注射治疗TMD的临床研究

Clinical study of upper temporomandibular joint cavity injection for TMD

目的:探讨医用几丁糖和透明质酸钠凝胶颞下颌关节上腔注射治疗颞下颌关节关节盘前移位的临床效果。方法:选取2015年1月~2015年12月期间于广州医科大学附属口腔医院颞下颌关节科治疗的颞下颌关节关节盘前移位患者200例。将患者随机分为两组进行治疗:第一组100例,患者采用关节上腔单针灌洗+透明质酸钠凝胶注射治疗;第二组100例,采用关节上腔单针灌洗+医用几丁糖注射法治疗。治疗前后常规行CBCT检查,MMO(最大张口度)和VAS(视觉类比量表)用于评估患者治疗前后张口度及颞下颌关节疼痛值的变化。结果:第一组总有效率为88%(88/100),第二组总有效率为90%(90/100)。经统计学分析,两组治疗效果均良好,但两组间差异无统计学意义(P> 0. 05),两组治疗3个月、6个月、12个月后随访结果无显著性差异。结论:医用几丁糖和透明质酸钠凝胶行关节上腔注射治疗颞下颌关节不可复性盘前移位的效果均良好,注射医用几丁糖与透明质酸钠凝胶效果基本相似。

Objective:To investigate the clinical effect of chitinose and sodium hyaluronate gel in the treatment of ADDWR(anterior disk displacement without reduction).Methods:200 patients with ADDWR treated in our department from 2015 January to December were selected in the study.Patients were randomly divided into two groups for treatment.100 patients of the first group were treated by Hyaluronate injection;100 patients in the second group were treated by injection of medical Chitosan.CBCT was performed before and after treatment.MMO and VAS were evaluated and compared before and after treatment.Results:Effective rate of the first group is 88%.Effective rate of the second group is90%.By statistical analysis,the treatment effect was good in both groups,but there was no statistical significance between the two groups(P>0.05).There was no significant difference in follow-up results between the two groups after 3 months,6 months and 12 months.Conclusion:Both the clinical effects of treating anterior disk displacement without reduction by upper articular cavity injection of medical chitosan and hyaluronate are effective to some degree,and the both groups show almost the same treatment results.