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颞下颌关节不可复性盘移位患者治疗后髁突活动度的变化及影像学改变

Changes in condylar mobility and radiographic alterations after treatment in patients with non-reducing disc displacement of the temporomandibular joint.

作者信息

Sato S, Kawamura H

机构信息

Division of Maxillofacial Surgery, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan.

出版信息

Dentomaxillofac Radiol. 2006 Jul;35(4):289-94. doi: 10.1259/dmfr/92464710.

Abstract

OBJECTIVES

The purpose of this study was to examine changes in condylar mobility and morphological changes in the affected condyles after treatment in patients with non-reducing disc displacement of the temporomandibular joint (TMJ).

METHODS

Changes in condylar mobility and morphological changes of the condyle were examined radiographically in 55 patients who were diagnosed as having non-reducing disc displacement of the unilateral TMJ and had received pumping with injection of sodium hyaluronate. In all patients, standardized lateral oblique transcranial radiographs and panoramic jaw tomograms were taken both at initial visit and at 12 months or more follow-up (mean 28.1 months after treatment; range 12-104 months). 42 joints in 21 persons with no current or previous TMJ symptoms served as a control.

RESULTS

Clinical signs and symptoms improved after treatment in the patients. Condylar mobility significantly increased after treatment in patients (P<0.001), although it did not reach levels of the control group. Frequency of radiographic changes of the condyle significantly increased after treatment (P<0.005). In most of the patients, no or only mild changes were observed. Frequency of changes of the condyle in patients at follow-up was significantly greater than that in controls (P<0.001).

CONCLUSIONS

In the patients, condylar mobility increased in the subsequent course after treatment. However, bony changes of the condyle appeared more frequently. Long term-follow-up after treatment on bony changes of the condyle seems to be necessary in patients with non-reducing disc displacement of the TMJ.

摘要

目的

本研究旨在探讨颞下颌关节(TMJ)不可复性盘移位患者治疗后髁突活动度的变化以及患侧髁突的形态学改变。

方法

对55例诊断为单侧TMJ不可复性盘移位且接受透明质酸钠注射推注治疗的患者,通过影像学检查观察髁突活动度变化及髁突形态学改变。所有患者在初诊时及随访12个月或更长时间(治疗后平均28.1个月;范围12 - 104个月)均拍摄标准化的经颅侧斜位片和全景颌骨断层片。选取21例无当前或既往TMJ症状的个体的42个关节作为对照。

结果

患者治疗后临床体征和症状有所改善。患者治疗后髁突活动度显著增加(P < 0.001),尽管未达到对照组水平。治疗后髁突影像学改变的频率显著增加(P < 0.005)。大多数患者未见改变或仅见轻度改变。随访时患者髁突改变的频率显著高于对照组(P < 0.001)。

结论

患者治疗后在后续病程中髁突活动度增加。然而,髁突的骨质改变出现得更频繁。对于TMJ不可复性盘移位患者,似乎有必要对髁突的骨质改变进行治疗后的长期随访。

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