Yura Shinya
Department of Oral and Maxillofacial Surgery, Tonami General Hospital, 1-61, Shintomi-cho, Tonami, Toyama-ken 939-1395, Japan.
Br J Oral Maxillofac Surg. 2012 Oct;50(7):646-9. doi: 10.1016/j.bjoms.2011.10.014. Epub 2011 Nov 25.
To clarify the features of acute closed lock of the temporomandibular joint we compared the clinical condition of patients with acute and chronic closed lock, and investigated the natural history of acute closed lock. Forty patients with unilateral acute closed lock who were given no treatment and 40 patients with unilateral chronic closed lock were enrolled in the study. The duration of locking in those with acute closed lock ranged from 1 to 7 days, and that of those with chronic closed lock from 3 to 4 months. Differences between the groups in sex, age, maximum mouth opening, and joint pain were analysed. In those with acute closed lock who had had no treatment, maximum mouth opening and joint pain were measured at the initial visit and after 2, 4, 8, and 12 weeks. The number of dysfunctional joints was counted during each period and the natural course of the acute closed lock investigated. There were more women and older patients among those with chronic, than among those with acute, closed lock. We found no significant differences in the symptoms in the two groups. After 2 weeks of allowing the acute closed lock to take its natural course only 15 of the 40 had not resolved successfully, and after 12 weeks of taking its natural course only 2 had been unsuccessful. The number of joints that did not resolve successfully decreased progressively over time. Any treatment for acute closed lock should be easier and more effective than that of following its natural course.
为明确颞下颌关节急性闭锁的特征，我们比较了急性和慢性闭锁患者的临床情况，并研究了急性闭锁的自然病程。本研究纳入了40例未经治疗的单侧急性闭锁患者和40例单侧慢性闭锁患者。急性闭锁患者的闭锁持续时间为1至7天，慢性闭锁患者的闭锁持续时间为3至4个月。分析了两组在性别、年龄、最大开口度和关节疼痛方面的差异。对于未经治疗的急性闭锁患者，在初诊时以及2周、4周、8周和12周后测量其最大开口度和关节疼痛情况。在每个时间段统计功能障碍关节的数量，并研究急性闭锁的自然病程。慢性闭锁患者中的女性和老年患者比急性闭锁患者更多。我们发现两组症状无显著差异。在让急性闭锁自然发展2周后，40例中只有15例未成功缓解，在自然发展12周后只有2例未成功缓解。未成功缓解的关节数量随时间逐渐减少。任何针对急性闭锁的治疗都应比让其自然发展更容易且更有效。
