Objective:To observe the clinical effect of articular cavity injection combined with bite splint therapy for the treatment of anterior disc displacement without reduction(ADDWoR).Methods:The research subjects for this...Objective:To observe the clinical effect of articular cavity injection combined with bite splint therapy for the treatment of anterior disc displacement without reduction(ADDWoR).Methods:The research subjects for this study were 30 patients with ADDWoR treated in the temporomandibular joint specialist outpatient clinic from November 2018 to November 2019,with a disease duration of 1 to 6 months.The treatment group was treated with an articular cavity injection of sodium hyaluronate+bite splint.The control group was treated with a simple articular cavity injection of sodium hyaluronate.The two groups were followed up once every 2 weeks to evaluate the treatment effect and observe the clinical efficacy of the two groups.Statistical analysis was carried out using SPSS 24.0.t-test and general linear regression analysis were carried out to compare the data of both groups,andχ^(2)-test and binary logistic regression analysis were performed for pain index comparison.Results:There was no significant difference in terms of the efficacy of the treatment received by both groups.The mouth opening and joint pain of patients in both groups were significantly improved after treatment(P<0.001).Conclusion:Articular cavity injection of sodium hyaluronate and occlusal splint therapy are both effective and safe methods for treating ADDWoR.展开更多
Anterior repositioning splint(ARS)therapy is considered one of the most effective therapies for treating disc displacement-related temporomandibular disorders(TMDs),which account for a large proportion of TMD cases.Ow...Anterior repositioning splint(ARS)therapy is considered one of the most effective therapies for treating disc displacement-related temporomandibular disorders(TMDs),which account for a large proportion of TMD cases.Owing to the wide application of this therapy,the exact mechanism of remission has increasingly drawn attention.Given that practitioners have different views on ARS therapy,its indications are broadened,and operating methods diverged.This review attempts to provide an overview of ARS therapy and helps practitioners establish indications and suitable operating methods.Representative views in the past 10 years were summarised,and conclusions were drawn as follows:The mechanism of ARS therapy is mainly attributed to internal derangement correction,improvement of stress distribution and recently reported joint remodeling.It has an evident effect in the short term,and the most prevalent operating methods are protruding the mandible to the edge-to-edge position and wearing the ARS for 24 hours daily for 3-6 months.However,long-term stability is not optimal,and thus indications should be selected carefully.Notably,most of the clinical studies in this field are case analyses with low-quality evidence.Well-designed RCTs are required to further validate relevant theories.展开更多
The present research is focused on the numerical crack coalescence analysis of the micro-cracks and cracks produced during the cutting action of TBM disc cutters. The linear elastic fracture mechanics(LEFM) concepts a...The present research is focused on the numerical crack coalescence analysis of the micro-cracks and cracks produced during the cutting action of TBM disc cutters. The linear elastic fracture mechanics(LEFM) concepts and the maximum tangential stress criterion are used to investigate the micro crack propagation and its direction underneath the excavating discs. A higher order displacement discontinuity method with quadratic displacement discontinuity elements is used to estimate the stress intensity factors near the crack tips. Rock cutting mechanisms under single and double type discs are simulated by the proposed numerical method.The main purposes of the present modeling are to simulate the chip formation process of indented rocks by single and double discs.The effects of specific disc parameters(except speed) on the thrust force Ft, the rolling force Fr, and the specific energy ES are investigated. It has been shown that the specific energy(energy required to cut through a unit volume of rock) of the double disc is less than that of the single disc. Crack propagation in rocks under disc cutters is numerically modeled and the optimum ratio of disc spacing S to penetration depth Pd(i.e. S/Pd ratio) of about 10 is obtained, which is in good agreement with the theoretical and experimental results cited in the literature.展开更多
Posterior disc displacement of the temporomandibular joint is rare. We present a unique treatment method and magnetic resonance (MR) images of this condition. The patient was a 43-year-old male with a chief complaint ...Posterior disc displacement of the temporomandibular joint is rare. We present a unique treatment method and magnetic resonance (MR) images of this condition. The patient was a 43-year-old male with a chief complaint of abnormal occlusion. Regarding the present status, there was no occlusion on the right side. No temporomandibular joint pain, myalgia, or clicking were observed while mouth opening. On MR images, the posterior disc displacement without reduction on the right was observed and it was assumed that occlusal abnormality was due to this condition. We treated him with the following methods. After injection into the superior articular cavity with 2% lidocaine, a sodium hyaluronate preparation was injected followed by intermaxillary traction applied using rubber. The recovery of occlusion was confirmed in follow-up at 5 days after treatment. In the 13th days, the intermaxillary traction was removed. On MR images, the right disc condition was changed to anterior disc displacement with reduction. We consider our treatment methods are effective for this clinical condition.展开更多
目的:通过Meta分析,比较手法复位联合咬合板治疗颞下颌关节盘不可复性前移位患者疼痛与最大张口度疗效是否优于仅进行手法或仅进行咬合板治疗。方法:计算机检索Web of Science、PubMed、Cochrane Library、维普(VIP)、中国知网(CNKI)、...目的:通过Meta分析,比较手法复位联合咬合板治疗颞下颌关节盘不可复性前移位患者疼痛与最大张口度疗效是否优于仅进行手法或仅进行咬合板治疗。方法:计算机检索Web of Science、PubMed、Cochrane Library、维普(VIP)、中国知网(CNKI)、万方中手法复位联合咬合板治疗颞下颌关节盘不可复性前移位的随机对照试验(RCTs)文献,并参考Cochrane手册评估文献质量,运用RevMan5.4软件分析结局指标。结果:本研究纳入6个RCTs,患者共计393例。Meta分析结果显示,对于颞下颌关节盘不可复性前移位患者,观察组进行手法复位联合咬合板治疗,在降低疼痛评分[SMD=-0.34,95%CI(-0.54,-0.13),P=0.001]与改善最大张口度[SMD=0.51,95%CI(0.31,0.71),P<0.00001]方面疗效均比对照组较优,差异具有统计学意义(P<0.05)。结论:手法复位联合咬合板治疗改善颞下颌关节盘不可复性前移位患者疼痛和最大张口度疗效优于单独使用手法复位或单独佩戴咬合板。展开更多
文摘Objective:To observe the clinical effect of articular cavity injection combined with bite splint therapy for the treatment of anterior disc displacement without reduction(ADDWoR).Methods:The research subjects for this study were 30 patients with ADDWoR treated in the temporomandibular joint specialist outpatient clinic from November 2018 to November 2019,with a disease duration of 1 to 6 months.The treatment group was treated with an articular cavity injection of sodium hyaluronate+bite splint.The control group was treated with a simple articular cavity injection of sodium hyaluronate.The two groups were followed up once every 2 weeks to evaluate the treatment effect and observe the clinical efficacy of the two groups.Statistical analysis was carried out using SPSS 24.0.t-test and general linear regression analysis were carried out to compare the data of both groups,andχ^(2)-test and binary logistic regression analysis were performed for pain index comparison.Results:There was no significant difference in terms of the efficacy of the treatment received by both groups.The mouth opening and joint pain of patients in both groups were significantly improved after treatment(P<0.001).Conclusion:Articular cavity injection of sodium hyaluronate and occlusal splint therapy are both effective and safe methods for treating ADDWoR.
文摘Anterior repositioning splint(ARS)therapy is considered one of the most effective therapies for treating disc displacement-related temporomandibular disorders(TMDs),which account for a large proportion of TMD cases.Owing to the wide application of this therapy,the exact mechanism of remission has increasingly drawn attention.Given that practitioners have different views on ARS therapy,its indications are broadened,and operating methods diverged.This review attempts to provide an overview of ARS therapy and helps practitioners establish indications and suitable operating methods.Representative views in the past 10 years were summarised,and conclusions were drawn as follows:The mechanism of ARS therapy is mainly attributed to internal derangement correction,improvement of stress distribution and recently reported joint remodeling.It has an evident effect in the short term,and the most prevalent operating methods are protruding the mandible to the edge-to-edge position and wearing the ARS for 24 hours daily for 3-6 months.However,long-term stability is not optimal,and thus indications should be selected carefully.Notably,most of the clinical studies in this field are case analyses with low-quality evidence.Well-designed RCTs are required to further validate relevant theories.
文摘The present research is focused on the numerical crack coalescence analysis of the micro-cracks and cracks produced during the cutting action of TBM disc cutters. The linear elastic fracture mechanics(LEFM) concepts and the maximum tangential stress criterion are used to investigate the micro crack propagation and its direction underneath the excavating discs. A higher order displacement discontinuity method with quadratic displacement discontinuity elements is used to estimate the stress intensity factors near the crack tips. Rock cutting mechanisms under single and double type discs are simulated by the proposed numerical method.The main purposes of the present modeling are to simulate the chip formation process of indented rocks by single and double discs.The effects of specific disc parameters(except speed) on the thrust force Ft, the rolling force Fr, and the specific energy ES are investigated. It has been shown that the specific energy(energy required to cut through a unit volume of rock) of the double disc is less than that of the single disc. Crack propagation in rocks under disc cutters is numerically modeled and the optimum ratio of disc spacing S to penetration depth Pd(i.e. S/Pd ratio) of about 10 is obtained, which is in good agreement with the theoretical and experimental results cited in the literature.
文摘Posterior disc displacement of the temporomandibular joint is rare. We present a unique treatment method and magnetic resonance (MR) images of this condition. The patient was a 43-year-old male with a chief complaint of abnormal occlusion. Regarding the present status, there was no occlusion on the right side. No temporomandibular joint pain, myalgia, or clicking were observed while mouth opening. On MR images, the posterior disc displacement without reduction on the right was observed and it was assumed that occlusal abnormality was due to this condition. We treated him with the following methods. After injection into the superior articular cavity with 2% lidocaine, a sodium hyaluronate preparation was injected followed by intermaxillary traction applied using rubber. The recovery of occlusion was confirmed in follow-up at 5 days after treatment. In the 13th days, the intermaxillary traction was removed. On MR images, the right disc condition was changed to anterior disc displacement with reduction. We consider our treatment methods are effective for this clinical condition.
文摘目的:通过Meta分析,比较手法复位联合咬合板治疗颞下颌关节盘不可复性前移位患者疼痛与最大张口度疗效是否优于仅进行手法或仅进行咬合板治疗。方法:计算机检索Web of Science、PubMed、Cochrane Library、维普(VIP)、中国知网(CNKI)、万方中手法复位联合咬合板治疗颞下颌关节盘不可复性前移位的随机对照试验(RCTs)文献,并参考Cochrane手册评估文献质量,运用RevMan5.4软件分析结局指标。结果:本研究纳入6个RCTs,患者共计393例。Meta分析结果显示,对于颞下颌关节盘不可复性前移位患者,观察组进行手法复位联合咬合板治疗,在降低疼痛评分[SMD=-0.34,95%CI(-0.54,-0.13),P=0.001]与改善最大张口度[SMD=0.51,95%CI(0.31,0.71),P<0.00001]方面疗效均比对照组较优,差异具有统计学意义(P<0.05)。结论:手法复位联合咬合板治疗改善颞下颌关节盘不可复性前移位患者疼痛和最大张口度疗效优于单独使用手法复位或单独佩戴咬合板。
