Sato Shuichi, Kawamura Hiroshi
Division of Maxillofacial Surgery, Tohoku University Graduate School of Dentistry, Sendai, Japan.
J Oral Maxillofac Surg. 2008 Mar;66(3):436-40. doi: 10.1016/j.joms.2007.09.004.
The purpose of this study was to investigate whether an additional mouth opening exercise contributes to better outcome in patients with nonreducing disc displacement who underwent pumping of the temporomandibular joint (TMJ).
Twenty-three female patients with nonreducing disc displacement of the TMJ underwent pumping of the TMJ and did mouth opening exercise after this treatment (rehabilitation group). Thirty-six female patients with nonreducing disc displacement of the TMJ underwent pumping of the TMJ, but did not do mouth opening exercise (non-rehabilitation group). Patients' signs and symptoms were examined monthly. Clinical evaluation was conducted according to the criteria presented by the 1995 American Association of Oral and Maxillofacial Surgeons. Outcomes were compared between the 2 groups at 12-month follow-up. Chi-square tests were used to assess the difference in good resolution rate between the 2 groups. When significant difference was not found, a non-inferiority test (Delta = 0.1) was used. Level of significance was set on P values less than .05.
In both groups, clinical signs and symptoms improved. There was a good resolution rate of 60.9% in the rehabilitation group and 75% in the non-rehabilitation group. No significant difference was observed between the 2 groups. The non-inferiority test showed that the good resolution rate of the non-rehabilitation group was significantly equivalent or more to that of the rehabilitation group (P < .05).
Mouth opening exercise did not seem to contribute to better outcomes in patients with nonreducing disc displacement who underwent pumping of the TMJ.
本研究旨在调查额外的开口练习是否有助于接受颞下颌关节（TMJ）灌注治疗的不可复性盘移位患者获得更好的治疗效果。
23例患有TMJ不可复性盘移位的女性患者接受了TMJ灌注治疗，并在治疗后进行开口练习（康复组）。36例患有TMJ不可复性盘移位的女性患者接受了TMJ灌注治疗，但未进行开口练习（非康复组）。每月检查患者的体征和症状。根据1995年美国口腔颌面外科医师协会提出的标准进行临床评估。在12个月的随访中比较两组的治疗效果。采用卡方检验评估两组间良好缓解率的差异。当未发现显著差异时，使用非劣效性检验（Delta = 0.1）。显著性水平设定为P值小于0.05。
两组患者的临床体征和症状均有改善。康复组的良好缓解率为60.9%，非康复组为75%。两组间未观察到显著差异。非劣效性检验表明，非康复组的良好缓解率显著等同于或高于康复组（P < 0.05）。
对于接受TMJ灌注治疗的不可复性盘移位患者，开口练习似乎并未有助于获得更好的治疗效果。
