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慢性双侧下颌髁突脱位的杠杆作用保守复位

Conservative reduction by lever action of chronic bilateral mandibular condyle dislocation.

作者信息

Ogawa Masaru, Kanbe Tomoyuki, Kano Akio, Kubota Fumitaka, Makiguchi Takaya, Miyazaki Hidetaka, Yokoo Satoshi

出版信息

Cranio. 2015 Apr;33(2):142-7. doi: 10.1179/0886963414Z.00000000041. Epub 2014 Apr 14.

Abstract

AIMS

The treatment of long-standing dislocation of the temporomandibular joint is broadly classified into open reduction and closed reduction. The current study presents a case of long-standing dislocation of the temporomandibular joint treated 3 years after dislocation. In this study, the authors evaluated the long-term outcome of conservative reduction by lever action of chronic bilateral mandibular condyle dislocation.

METHODOLOGY

Manual repositioning of temporomandibular joint dislocation lasting for 3 years in a 31-year-old woman was attempted without success; therefore, conservative reduction by lever action was carried out because the patient declined treatment under general anesthesia.

RESULTS

The treatment was discontinued after 6 days because of the subluxation of the retaining tooth. The retainer was changed from tooth to screw for intermaxillary fixation, and treatment was reinstituted. Fifteen days later, reduction was achieved and retention was started and continued for 2 months. The outcome was good, with no recurrent dislocation within 24 months of the treatment.

CONCLUSIONS

Conservative reduction by lever action, involving minimally invasive treatment and little dysfunction, should be considered an optional conservative treatment.

摘要

目的

颞下颌关节长期脱位的治疗大致分为开放复位和闭合复位。本研究介绍了1例脱位3年后才接受治疗的颞下颌关节长期脱位病例。在本研究中,作者评估了通过杠杆作用对慢性双侧下颌髁突脱位进行保守复位的长期效果。

方法

尝试对一名31岁女性持续3年的颞下颌关节脱位进行手动复位,但未成功;因此,由于患者拒绝在全身麻醉下接受治疗,遂通过杠杆作用进行保守复位。

结果

由于固位牙半脱位,6天后治疗中断。将固位方式从牙改为颌间固定螺钉,重新开始治疗。15天后,实现复位并开始固位,持续2个月。结果良好,治疗后24个月内无复发性脱位。

结论

通过杠杆作用进行保守复位,具有微创治疗且功能障碍小的特点,应被视为一种可选的保守治疗方法。

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