Hegab Ayman F
Department of oral & maxillofacial surgery- faculty of dental medicine-Al-Azhar University, Cairo, Egypt.
Br J Oral Maxillofac Surg. 2013 Dec;51(8):813-7. doi: 10.1016/j.bjoms.2013.04.010. Epub 2013 May 16.
Our aim was to evaluate the efficacy of autologous blood injection in the treatment of chronic recurrent dislocation of the temporomandibular joint (TMJ) in a prospective randomised controlled clinical study. Forty-eight patients (11 men and 37 women) with chronic recurrent dislocation of the TMJ were randomly assigned to 1 of 3 equally sized groups. Patients in the first group were treated with injection of autologous blood (ABI) alone into the superior joint space and the pericapsular tissues. Those in the second group were treated with intramaxillary fixation (IMF) alone for 4 weeks, and those in the third group were treated with ABI and IMF for 4 weeks. Interincisal distance, digital panoramic radiograph, incidence of recurrent dislocation, and pain in the TMJ were assessed postoperatively at 2 weeks and at 1, 3, 6, and 12 months. The mean (SD) reduction in interincisal distance in the group treated with both techniques was 11.0 (1.9), which was significantly higher than in either the group treated with ABI, which was 8.5 (2.4) or IMF, which was 9.1 (2.1). The results in the ABI group and the IMF group did not differ significantly. The combined group showed the biggest decrease. The ABI alone group had the most recurrences (n=8, which were treated by repeated injections with no recurrence after the third). The IMF alone group had only 3 and there were none in the combined group. We conclude that ABI is a simple and safe technique for the treatment of dislocation of the TMJ in the outpatient clinic. Recurrence can be overcome by multiple injections. However, the best clinical results are given by a combination of ABI and IMF.
我们的目的是在一项前瞻性随机对照临床研究中,评估自体血注射治疗颞下颌关节(TMJ)慢性复发性脱位的疗效。48例TMJ慢性复发性脱位患者(11例男性,37例女性)被随机分为3个同等规模的组。第一组患者仅接受向上关节间隙和关节囊周围组织注射自体血(ABI)治疗。第二组患者仅接受颌间固定(IMF)4周,第三组患者接受ABI联合IMF治疗4周。术后2周以及1、3、6和12个月时评估切牙间距离、数字化全景X线片、复发性脱位发生率和TMJ疼痛情况。两种技术联合治疗组的切牙间距离平均(标准差)减小值为11.0(1.9),显著高于仅接受ABI治疗组的8.5(2.4)和仅接受IMF治疗组的9.1(2.1)。ABI组和IMF组的结果无显著差异。联合组减小幅度最大。仅接受ABI治疗组复发最多(n = 8,经重复注射治疗,第三次注射后无复发)。仅接受IMF治疗组仅有3例复发,联合组无复发。我们得出结论,ABI是门诊治疗TMJ脱位的一种简单且安全的技术。多次注射可克服复发问题。然而,ABI与IMF联合使用可获得最佳临床效果。