Ma ZhiGui, Xie QianYang, Yang Chi, Zhang ShanYong, Shen YuQing, Cai XieYi
From the Department of Oral Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, School of Medicine, Shanghai, P.R. China.
J Craniofac Surg. 2015 Mar;26(2):e78-81. doi: 10.1097/SCS.0000000000001392.
This study aimed to evaluate the changes of temporomandibularjoint (TMJ) space in the treatment of disk displacement with reduction (DDWR) for class II cases. Forty-two adolescent patients with unilateral DDWR, who were successfully treated by functional appliance, were selected in this study. Magnetic resonance imaging scans were used before treatment (T1), at the start of treatment (T2), and after functional treatment (T3). Compared with the normal joint, the change of joint space index was calculated. The anterior, posterior, and superior joint spaces were analyzed on the largest sagittal plane among T1, T2, and T3. Student's t-test was used for statistical analysis. The mean treatment period was 10 months (6-16 mo). Functional appliance was effective in eliminating pain and clicking. During the phase of T1, the value of the joint space index of DDWR was significantly higher than that of the control (P < 0.05). There was a significant decrease in the anterior space and an increase in the postsuperior space at T2 (P < 0.01), and then the contrary changes occurred at T3. However, there was a significant increase in the postsuperior space and no significant decrease in the anterior space when T1 and T3 were compared. This study indicates that the TMJ space is well distributed after disk repositioning with functional treatment of DDWR. It is also suggested that the adaptive remodeling in TMJ occurs via functional treatment.
本研究旨在评估功能性矫治器治疗安氏II类可复性盘前移位（DDWR）患者时颞下颌关节（TMJ）间隙的变化。本研究选取了42例单侧DDWR的青少年患者，这些患者均通过功能性矫治器成功治疗。在治疗前（T1）、治疗开始时（T2）以及功能性治疗后（T3）进行磁共振成像扫描。计算关节间隙指数相对于正常关节的变化。在T1、T2和T3最大矢状面上分析关节前间隙、后间隙和上间隙。采用Student t检验进行统计学分析。平均治疗周期为10个月（6 - 16个月）。功能性矫治器在消除疼痛和弹响方面有效。在T1阶段，DDWR关节间隙指数值显著高于对照组（P < 0.05）。在T2时，前间隙显著减小，后上间隙增大（P < 0.01），而在T3时出现相反变化。然而，当比较T1和T3时，后上间隙显著增大，前间隙无显著减小。本研究表明，通过功能性矫治器治疗DDWR使盘复位后，TMJ间隙分布良好。同时也提示，TMJ通过功能性治疗发生适应性重塑。
