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用于颞下颌关节盘复位的Mitek微型锚钉:手术技术与结果

The Mitek mini anchor for TMJ disc repositioning: surgical technique and results.

作者信息

Mehra P, Wolford L M

机构信息

Department of Oral and Maxillofacial Surgery, Boston University Medical Center and Boston University School of Dental Medicine, MA, USA.

出版信息

Int J Oral Maxillofac Surg. 2001 Dec;30(6):497-503. doi: 10.1054/ijom.2001.0163.

Abstract

This study evaluated our treatment outcomes in 105 patients (188 discs) using the Mitek mini anchor for temporomandibular joint (TMJ) articular disc repositioning surgery, with 88 patients having simultaneous orthognathic surgery. Criteria for inclusion into the study were: (1) Presurgical TMJ disc displacement with salvageable disc; (2) No prior TMJ surgery; (3) TMJ disc repositioning with the Mitek mini anchor; (4) Absence of connective tissue/autoimmune disease; (5) Absence of postsurgical trauma; and (6) Minimum of 12 months postsurgery follow up. Presurgery (T1), immediately postsurgery (T2), and longest follow up (LFU) clinical and radiographic evaluations were performed. The mean age of the patients was 32.6 years (range 14-57 years), and mean follow-up time was 46.2 months (range 14-84 months). Radiographic evaluation at LFU demonstrated no significant condylar resorption or positional changes of the anchors. At LFU, there was a statistically significant reduction in: TMJ pain, facial pain, headaches, TMJ noises and disability, and improvement in jaw function and diet. Maximum incisal opening improved slightly and lateral excursive movements decreased slightly. The Mitek mini anchor provides a predictable method for stabilizing the TMJ articular disc to the condyle and a high success rate in decreasing TMJ dysfunction and pain in patients with no previous TMJ surgery.

摘要

本研究评估了我们使用Mitek微型锚钉对105例患者(188个椎间盘)进行颞下颌关节(TMJ)关节盘复位手术的治疗结果,其中88例患者同时进行了正颌手术。纳入本研究的标准为:(1)术前TMJ盘移位且盘可挽救;(2)既往未行TMJ手术;(3)使用Mitek微型锚钉进行TMJ盘复位;(4)无结缔组织/自身免疫性疾病;(5)无术后创伤;(6)术后随访至少12个月。进行了术前(T1)、术后即刻(T2)和最长随访(LFU)的临床和影像学评估。患者的平均年龄为32.6岁(范围14 - 57岁),平均随访时间为46.2个月(范围14 - 84个月)。LFU时的影像学评估显示髁突无明显吸收或锚钉位置改变。在LFU时,以下各项有统计学意义的降低:TMJ疼痛、面部疼痛、头痛、TMJ弹响和功能障碍,并且下颌功能和饮食有所改善。最大切牙开口度略有改善,侧向运动略有减少。Mitek微型锚钉为将TMJ关节盘稳定于髁突提供了一种可预测的方法,对于既往未行TMJ手术的患者,在降低TMJ功能障碍和疼痛方面成功率较高。

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