Yang Jung-Wu, Huang Yi-Chia, Wu Shang-Liang, Ko Shun-Yao, Tsai Chiang-Chin
Department of Oral and Maxillofacial Surgery, Tainan Sin Lau Hospital, The Presbyterian Church Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University Yuan Yuan Dental Federation, Tainan, Taiwan School of Medicine, Griffith University, Gold Coast, Australia Department of General Surgery, Tainan Sin Lau Hospital, The Presbyterian Church Department of Health Care Administration, Chang Jung Christian University, Tainan, Taiwan.
Medicine (Baltimore). 2017 Mar;96(11):e6302. doi: 10.1097/MD.0000000000006302.
The agony that accompanies the incidence and symptoms of temporomandibular disorders (TMDs) is an important concern in the oral and maxillofacial region. The objective of this study was to explore the clinical findings after centric relation occlusal splint (CROS) treatment and intra-articular injection treatment with liquid phase concentrated growth factors (LPCGFs) in patients with disc displacement without reduction (DDWOR).The group under investigation of this retrospective cohort study included patients with DDWOR who received treatment from April 2014 until March 2016. The predictor variable was the therapeutic method. The outcome variables included joint crepitus sound, visual analog scale (VAS) of temporomandibular joint (TMJ) arthralgia, TMD-associated headache, myofascial pain with referral, deviation of the mandible during opening (DoM), and maximal interincisal opening (MIO). At the stage of CROS treatment, evaluation of all variables adopted the individual as the unit; at the stage after LPCGF injection, the evaluation of joint sound adopted the joint as the unit, whereas the other variables adopted the individual as the unit.Among the 29 patients, 6 (20.68%) were males and 23 (79.31%) were females. Distribution by age ranged from 15 to 84 years (mean age 39.55 ± 15.49 years). After CROS treatment, except for the joint crepitus sound, which failed to achieve significant improvement (P > 0.05), other symptoms, such as DOM, TMD-associated headache, myofascial pain with referral, TMJ arthralgia, and MIO, all achieved statistically significant improvements (P < 0.05). After 2 mL of LPCGF was injected once after CROS treatment, 26 joint crepitus sound symptoms were relieved (P < 0.001) after an average of 48.5 ± 64.1 days.CROS alone can alleviate TMD clinical symptoms, except for the joint crepitus sound. Approximately 72.2% of joint crepitus sounds could be improved within 48 days, on average, once 2 mL of LPCGF was injected. Comparisons were still required in the future, with the effects of other therapeutic methods.
颞下颌关节紊乱病（TMDs）的发病及症状所伴随的疼痛是口腔颌面区域的一个重要问题。本研究的目的是探讨在不可复性盘前移位（DDWOR）患者中，采用正中关系咬合板（CROS）治疗及关节腔内注射液相浓缩生长因子（LPCGFs）后的临床疗效。这项回顾性队列研究的调查对象包括2014年4月至2016年3月期间接受治疗的DDWOR患者。预测变量为治疗方法。结局变量包括关节弹响、颞下颌关节（TMJ）疼痛的视觉模拟量表（VAS）、TMD相关头痛、牵涉性肌筋膜疼痛、开口时下颌偏斜（DoM）以及最大切牙间开口度（MIO）。在CROS治疗阶段，所有变量的评估以个体为单位；在LPCGF注射后的阶段，关节弹响的评估以关节为单位，而其他变量以个体为单位。
29例患者中，男性6例（20.68%），女性23例（79.31%）。年龄分布为15至84岁（平均年龄39.55±15.49岁）。CROS治疗后，除关节弹响未取得显著改善（P>0.05）外，其他症状，如DoM、TMD相关头痛、牵涉性肌筋膜疼痛、TMJ疼痛及MIO均取得了统计学上的显著改善（P<0.05）。CROS治疗后一次性注射2 mL LPCGF，平均48.5±64.1天后，26例关节弹响症状得到缓解（P<0.001）。
单纯CROS可缓解TMD的临床症状，但关节弹响除外。平均注射2 mL LPCGF后，约72.2%的关节弹响症状可在48天内得到改善。未来仍需与其他治疗方法的效果进行比较。
