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关节穿刺术与颞下颌关节紊乱病:一项前瞻性研究的临床及影像学结果

Arthrocentesis and temporomandibular joint disorders: clinical and radiological results of a prospective study.

作者信息

De Riu Giacomo, Stimolo Mirella, Meloni Silvio Mario, Soma Damiano, Pisano Milena, Sembronio Salvatore, Tullio Antonio

机构信息

UOC Maxillo-Facciale, Dipartimento di Scienze Chirurgiche, Microchirurgiche e Mediche, Università degli Studi di Sassari, V. le San Pietro 43, 07100 Sassari, Italy.

出版信息

Int J Dent. 2013;2013:790648. doi: 10.1155/2013/790648. Epub 2013 Nov 11.

Abstract

Purpose. We evaluated the efficacy of arthrocentesis in the treatment of temporomandibular joint (TMJ) disorders. Material and Methods. In this prospective clinical case series, 30 consecutive patients with TMJ disorders underwent arthrocentesis using saline and sodium hyaluronate injections. Outcome measures were TMJ pain, maximum mouth opening (MMO), joint noises, and anatomical changes in the TMJ architecture. Patients were evaluated using cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) at the beginning of treatment and 60 days after the last arthrocentesis. Pretreatment and posttreatment clinical parameters were compared using paired and unpaired t-tests, and McNemar's test was used to evaluate CBCT and MRI changes (P < 0.05). Results. At 1-year follow-up examinations, visual analogue scale scores indicated that pain was reduced significantly and mean postoperative MMO was increased significantly. CBCT findings showed no significant change, and MRI showed only slight reductions in inflammatory signs. Conclusions. Within the limitations of this study, we can conclude that arthrocentesis is a simple, minimally invasive procedure with a relatively low risk of complications and significant clinical benefits in patients with TMJ disorders. This trial is registered with NCT01903512.

摘要

目的。我们评估了关节穿刺术治疗颞下颌关节(TMJ)疾病的疗效。材料与方法。在这个前瞻性临床病例系列中,30例连续的TMJ疾病患者接受了使用生理盐水和透明质酸钠注射的关节穿刺术。观察指标包括TMJ疼痛、最大开口度(MMO)、关节弹响以及TMJ结构的解剖学变化。在治疗开始时以及最后一次关节穿刺术后60天,使用锥形束计算机断层扫描(CBCT)和磁共振成像(MRI)对患者进行评估。使用配对和非配对t检验比较治疗前和治疗后的临床参数,并使用McNemar检验评估CBCT和MRI的变化(P < 0.05)。结果。在1年的随访检查中,视觉模拟量表评分表明疼痛显著减轻,术后平均MMO显著增加。CBCT检查结果显示无显著变化,MRI仅显示炎症征象略有减轻。结论。在本研究的局限性范围内,我们可以得出结论,关节穿刺术是一种简单、微创的手术,并发症风险相对较低,对TMJ疾病患者具有显著的临床益处。本试验已在NCT01903512注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfa/3844254/265fac34bd86/IJD2013-790648.001.jpg

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