Daif Emad T
Faculty of Oral & Dental Medicine, Cairo University, Cairo, Egypt.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jan;109(1):31-6. doi: 10.1016/j.tripleo.2009.08.002.
Many different surgical and nonsurgical techniques have been used to treat patients with chronic recurrent temporomandibular joint (TMJ) dislocation. The nonsurgical techniques consist of injecting different substances into the TMJ area. This study was carried out to assess autologous blood injection to the TMJ for treatment of chronic recurrent TMJ dislocation.
Thirty patients having chronic recurrent TMJ dislocation were randomly divided into 2 equal groups (15 patients in each). Group A was treated only by autologous blood injection into the superior joint space (SJS), whereas group B received autologous blood injections to the SJS and the pericapsular tissues (PT).
At the end of the follow-up period of 1 year, the results of the current study have showed that injection of autologous blood to the SJS and PT gave a higher success rate (80%) than its injection only into the SJS (60%). Moreover, the patients of group B had an average decrease in their maximal mouth opening (5.3 +/- 2.1) higher than that of group A (3.6 +/- 1.5). Also, the digital radiographic imaging of the joints in group B only showed the condylar head posterior to the articular eminence, in open position, instead of being anterior to it before the injection. In both groups, no destructive changes to the bony components of the joint have been observed.
We could conclude from this study that the injection of autologous blood into the TMJ in patients with chronic recurrent dislocation is a simple, safe and cost-effective technique. So, we encourage injection of autologous blood to the SJS and PT for treatment of patients with chronic recurrent TMJ dislocation, as it has shown better clinical and radiographic results than its injection only to the SJS.
许多不同的手术和非手术技术已被用于治疗慢性复发性颞下颌关节(TMJ)脱位患者。非手术技术包括向TMJ区域注射不同物质。本研究旨在评估自体血注射到TMJ用于治疗慢性复发性TMJ脱位的效果。
30例慢性复发性TMJ脱位患者被随机分为2组,每组15例。A组仅通过向上关节腔(SJS)注射自体血进行治疗,而B组则向SJS和关节囊周围组织(PT)注射自体血。
在1年的随访期结束时,本研究结果表明,向SJS和PT注射自体血的成功率(80%)高于仅向SJS注射(60%)。此外,B组患者的最大开口度平均下降(5.3±2.1)高于A组(3.6±1.5)。而且,仅B组关节的数字化放射成像显示,在开口位时髁突位于关节结节后方,而注射前位于其前方。两组均未观察到关节骨成分的破坏性改变。
我们可以从本研究得出结论,向慢性复发性脱位患者的TMJ注射自体血是一种简单、安全且经济有效的技术。因此,我们鼓励向SJS和PT注射自体血来治疗慢性复发性TMJ脱位患者,因为它已显示出比仅向SJS注射更好的临床和影像学结果。