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关节镜下髁突成形术:颞下颌关节内紊乱的一种新的治疗选择。

Arthroscopic eminoplasty: a new choice of treatment for TMJ internal derangement.

作者信息

Garcia Medina Blas, Cariati Paolo, Galvez Pablo, Cabello Serrano Almudena, Garcia Martin Miguel

机构信息

Hospital Virgen de las Nieves, Granada, Spain.

Hospital Virgen de las Nieves, Granada, Spain -

出版信息

Minerva Stomatol. 2017 Aug;66(4):141-147. doi: 10.23736/S0026-4970.17.04065-1. Epub 2017 Jun 9.

Abstract

BACKGROUND

Temporomandibular joint (TMJ) internal derangement is a common disabling disorder that is often underestimated by society. The main goal of our study was to show the clinic improvement experienced by patients that underwent arthroscopic eminoplasty as a treatment for TMJ in our center.

METHODS

Nineteen patients (1 male, 18 females) agreed to participate voluntarily in our study. These patients presented signs and symptoms of TMJ internal derangement and pathological MRI images, and underwent arthroscopic eminoplasty in our center. A patient database was created to record Wilkes stages, type of surgical intervention, complications, and preoperative and postoperative pain and mouth opening.

RESULTS

Our data showed that TMJ pain (measured 6 months before surgery) was higher (M=7.44, SD=1.44; t(18)=8.37, P<0.01) than the pain registered eighteen months after surgery (M=3.10, SD=2.40). Moreover, postoperative mouth opening (M=33.6 SD=7.92) was greater than preoperative mouth opening.

CONCLUSIONS

The results indicate that this technique is effective in reducing pain and increasing mouth opening with minimal postoperative morbidity. Specifically, this technique minimizes the stress suffered by the joint disc at the narrowest points of joint space and increases articular stability.

摘要

背景

颞下颌关节(TMJ)内紊乱是一种常见的致残性疾病,常被社会低估。我们研究的主要目的是展示在我们中心接受关节镜下髁突成形术治疗颞下颌关节的患者所经历的临床改善情况。

方法

19名患者(1名男性,18名女性)自愿同意参与我们的研究。这些患者呈现出颞下颌关节内紊乱的体征和症状以及病理性MRI图像,并在我们中心接受了关节镜下髁突成形术。创建了一个患者数据库来记录威尔克斯分期、手术干预类型、并发症以及术前和术后的疼痛和张口情况。

结果

我们的数据显示,颞下颌关节疼痛(手术前6个月测量)(M = 7.44,标准差 = 1.44;t(18) = 8.37,P < 0.01)高于手术后18个月记录的疼痛(M = 3.10,标准差 = 2.40)。此外,术后张口度(M = 33.6,标准差 = 7.92)大于术前张口度。

结论

结果表明,该技术在减轻疼痛和增加张口度方面有效,且术后发病率最低。具体而言,该技术将关节盘在关节间隙最窄点所承受的应力降至最低,并增加了关节稳定性。

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