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两种颞下颌关节全关节假体系统的比较。

Comparison of 2 temporomandibular joint total joint prosthesis systems.

作者信息

Wolford Larry M, Dingwerth Douglas J, Talwar Reena M, Pitta Marcos C

机构信息

Department of Oral and Maxillofacial Surgery, Baylor College of Dentistry, Texas A&M University, Dallas, TX, USA.

出版信息

J Oral Maxillofac Surg. 2003 Jun;61(6):685-90; discussion 690. doi: 10.1053/joms.2003.50112.

Abstract

PURPOSE

The study goal was to evaluate the comparative outcomes of patients treated with temporomandibular joint (TMJ) total joint prostheses, using either the Christensen prosthesis (TMJ Inc, Golden, CO) (CP) or the TMJ Concepts prosthesis (TMJ Concepts Inc, Camarillo, CA; formerly Techmedica Inc) (TP).

PATIENTS AND METHODS

Forty-five consecutive patients treated with either CP or TP total joint prostheses were evaluated. The CP group consisted of 23 patients (40 prostheses; average patient age, 38.8 years). The TP group consisted of 22 patients (38 prostheses; average patient age, 38.5 years). The average number of previous operations for the CP group was 3.9, whereas it was 2.6 for the TP group. The CP and TP groups had an average follow-up of 20.8 and 33.0 months, respectively. Patients were evaluated for incisal opening and occlusal and skeletal stability. A visual analog scale was used for subjective assessment of TMJ pain (0 = no pain, 10 = worst pain), jaw function (0 = normal function, 10 = no function), and diet (0 = no limitations, 10 = liquids only). Statistical analysis was performed using an independent t test, and a value of P <.05 was considered significant.

RESULTS

The average postsurgical incisal opening for the CP group was 30.1 mm (increase of 6.7 mm), and that for the TP group was 37.3 mm (increase of 9.9 mm), indicating significant increase of the TP group (P =.008). The average postsurgical pain level for the CP group was 6.0, a decrease of 1.8, and that for the TP group was 4.1, a decrease of 3.1, indicating significant improvement for the TP group (P =.042). Postsurgical average jaw function for CP was 5.5, an improvement of 1.2. The postsurgical TP average was 3.9, an improvement of 3.0, showing significant improvement for the TP group (P =.008). Average postsurgical diet rating for the CP group was 5.4, an improvement of 1.8. The TP group average was 3.9, an improvement of 2.0, indicating significant improved eating ability for the TP group (P =.021). Skeletal and occlusal stability were good in both groups.

CONCLUSION

The TP group had statistically significant improved outcomes compared with the CP group relative to postsurgical incisal opening, pain, jaw function, and diet. Both groups showed good skeletal and occlusal stability.

摘要

目的

本研究的目标是评估使用克里斯滕森假体(TMJ Inc,戈尔登,科罗拉多州)(CP)或颞下颌关节概念假体(TMJ Concepts Inc,卡马里洛,加利福尼亚州;前身为Techmedica Inc)(TP)治疗的颞下颌关节(TMJ)全关节置换患者的比较结果。

患者与方法

对45例连续接受CP或TP全关节置换的患者进行评估。CP组由23例患者组成(40个假体;患者平均年龄38.8岁)。TP组由22例患者组成(38个假体;患者平均年龄38.5岁)。CP组既往手术的平均次数为3.9次,而TP组为2.6次。CP组和TP组的平均随访时间分别为20.8个月和33.0个月。对患者进行切牙开口度、咬合和骨骼稳定性评估。使用视觉模拟量表对TMJ疼痛(0 = 无疼痛,10 = 最严重疼痛)、下颌功能(0 = 正常功能,10 = 无功能)和饮食(0 = 无限制,10 = 仅流食)进行主观评估。采用独立t检验进行统计分析,P <.05被认为具有统计学意义。

结果

CP组术后切牙开口度平均为30.1 mm(增加6.7 mm),TP组为37.3 mm(增加9.9 mm),表明TP组有显著增加(P =.008)。CP组术后平均疼痛水平为6.0,下降了1.8,TP组为4.1,下降了3.1,表明TP组有显著改善(P =.042)。CP组术后平均下颌功能为5.5,改善了1.2。TP组术后平均为3.9,改善了3.0,表明TP组有显著改善(P =.008)。CP组术后平均饮食评分是5.4,改善了1.8。TP组平均为3.9,改善了2.0,表明TP组进食能力有显著改善(P =.021)。两组的骨骼和咬合稳定性均良好。

结论

与CP组相比,TP组在术后切牙开口度、疼痛、下颌功能和饮食方面的结果有统计学意义的显著改善。两组均显示出良好的骨骼和咬合稳定性。

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