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关节穿刺术联合透明质酸注射对不同年龄组颞下颌关节骨关节炎患者的治疗效果

Treatment effectiveness of arthrocentesis plus hyaluronic acid injections in different age groups of patients with temporomandibular joint osteoarthritis.

作者信息

Guarda-Nardini Luca, Olivo Marco, Ferronato Giuseppe, Salmaso Luigi, Bonnini Stefano, Manfredini Daniele

机构信息

Department of Maxillofacial Surgery, University of Padova, Padua, Italy.

出版信息

J Oral Maxillofac Surg. 2012 Sep;70(9):2048-56. doi: 10.1016/j.joms.2012.05.018.

Abstract

PURPOSE

To investigate for treatment effectiveness in different age groups of patients with temporomandibular joint osteoarthritis who underwent a cycle of 5 weekly arthrocenteses plus hyaluronic acid injections.

MATERIALS AND METHODS

We implemented a retrospective study on 76 patients followed up for 1 year. Outcome variables were pain levels at rest and during chewing, subjective masticatory efficiency, functional limitation, perceived efficacy, and jaw range of motion. Three age groups of patients were identified, and treatment effectiveness was compared among groups by means of a multistrata permutation test.

RESULTS

All the partial P values of the subtests related to the age groups, adjusted according to the close testing method for controlling multiplicity, were significant: P = .009 (aged <45 years), P = .001 (aged 45-65 years), and P = .001 (aged >65 years). For the younger age group, the treatment had a significant effect only on the pain at mastication and on the subjective efficacy. For the other age groups, the treatment effectiveness was evident with regard to almost all the considered symptoms.

CONCLUSIONS

Our findings suggested that the treatment protocol was more effective in patients older than 45 years, thus having important clinical implications regarding attempts to define tailored treatment protocols for patients with temporomandibular disorders.

摘要

目的

研究接受为期5周、每周1次的关节腔穿刺术加透明质酸注射治疗周期的不同年龄组颞下颌关节骨关节炎患者的治疗效果。

材料与方法

我们对76例患者进行了为期1年的回顾性研究。观察指标包括静息及咀嚼时的疼痛程度、主观咀嚼效率、功能受限情况、疗效感知以及下颌运动范围。确定了三个年龄组的患者,并通过多分层置换检验比较组间治疗效果。

结果

根据控制多重性的封闭检验方法调整后,与年龄组相关的各子检验的所有部分P值均具有统计学意义:P = 0.009(年龄<45岁),P = 0.001(年龄45 - 65岁),P = 0.001(年龄>65岁)。对于较年轻的年龄组,该治疗仅对咀嚼时的疼痛和主观疗效有显著影响。对于其他年龄组,几乎所有所考虑的症状的治疗效果都很明显。

结论

我们的研究结果表明,该治疗方案对45岁以上患者更有效,因此对于为颞下颌关节紊乱患者制定个性化治疗方案具有重要的临床意义。

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