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三百例采用 Biomet/Lorenz MicrofixationTMJ 置换系统修复的患者的十年经验及随访结果。

A ten-year experience and follow-up of three hundred patients fitted with the Biomet/Lorenz Microfixation TMJ replacement system.

机构信息

Department of Oral and Maxillofacial Surgery, Hospital Santa Paula, Sao Paulo, Brazil.

出版信息

Int J Oral Maxillofac Surg. 2013 Aug;42(8):1007-13. doi: 10.1016/j.ijom.2013.04.018. Epub 2013 Jun 12.

Abstract

The purpose of this paper is to present the postoperative results obtained after full temporomandibular joint (TMJ) reconstruction employing the Biomet/Lorenz Microfixation TMJ replacement system (Jacksonville, FL, USA) in 300 patients (201 unilateral, 99 bilateral). Objective data (maximum inter-incisal opening; MIO) and subjective data (function and speech, diet, and pain) were collected preoperatively and at postoperative evaluations performed over a 10-year period (mean 3.5, standard deviation 2.1 years). The MIO measures were obtained using a calliper rule. Subjective data were evaluated using a visual analogue scale with scores ranging from 0 to 5 for each variable. The results were analyzed with the paired t-test (two-sided, α=5%). Each patient showed significant improvements for all of the variables at evaluation on postoperative day 7. The results for MIO, function and speech, and diet, showed improvements at each postoperative evaluation over a maximum of 3 years, with stabilization of the results from the fourth year. Complaints of pain decreased considerably up to the 1-month postoperative evaluation, and no patient reported severe pain at 6 months after surgery. The results presented show that the reconstruction of the TMJ through the installation of the Biomet/Lorenz system prosthesis is a safe and effective option for proper reestablishment of the joint and stomatognathic system function; significant long-term improvements in mandibular range of motion are promoted and pain levels decrease.

摘要

本文旨在介绍使用 Biomet/Lorenz 微固定 TMJ 置换系统(美国杰克逊维尔)对 300 例患者(201 例单侧,99 例双侧)进行全颞下颌关节(TMJ)重建后的术后结果。术前和术后 10 年的评估中收集了客观数据(最大开口度;MIO)和主观数据(功能和言语、饮食和疼痛)(平均 3.5 年,标准偏差 2.1 年)。MIO 测量值使用卡尺规则获得。主观数据使用视觉模拟量表进行评估,每个变量的得分范围为 0 到 5。结果采用配对 t 检验(双侧,α=5%)进行分析。每位患者在术后第 7 天的评估中所有变量均显示出显著改善。MIO、功能和言语以及饮食的结果在最长 3 年的每次术后评估中均有所改善,从第 4 年开始结果稳定。疼痛的投诉在术后 1 个月的评估中显著减少,术后 6 个月没有患者报告严重疼痛。所呈现的结果表明,通过安装 Biomet/Lorenz 系统假体进行 TMJ 重建是一种安全有效的选择,可以正确重建关节和咀嚼系统功能;促进下颌运动范围的显著长期改善,并降低疼痛水平。

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