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关节穿刺抽液后自体血注射治疗慢性复发性颞下颌关节脱位的临床及影像学结果

Clinical and radiological outcome of arthrocentesis followed by autologous blood injection for treatment of chronic recurrent temporomandibular joint dislocation.

作者信息

Patel Jinesh, Nilesh Kumar, Parkar M I, Vaghasiya Alpesh

机构信息

MDS (OMFS), Post graduate student, Department of Oral and Maxillofacial Surgery, School of dental scienes,KIMSDU, Karad.

MDS (OMFS), Reader, Department of Oral and Maxillofacial Surgery, School of dental scienes,KIMSDU, Karad.

出版信息

J Clin Exp Dent. 2017 Aug 1;9(8):e962-e969. doi: 10.4317/jced.53812. eCollection 2017 Aug.

DOI:10.4317/jced.53812
PMID:28936285
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5601112/
Abstract

BACKGROUND

This study was conducted to evaluate the functional outcome and MRI findings of arthrocentsis followed by autologous blood injection (ABI) into the joint space for management of chronic recurrent TMJ dislocation.

MATERIAL AND METHODS

Total ten patients with bilateral chronic recurrent condylar dislocation were included in the study. Arthrocentesis of both TMJ was performed on each patient, followed by the injection of 2 ml of autologous blood into the superior joint compartment and 1 ml onto the outer surface of the joint capsule. Preoperative and postoperative assessment included; thorough history, clinical examination of TMJ, maximal mouth opening, frequency of dislocation, TMJ radiographs (open and closed mouth position), MRI, recurrence and presence of facial nerve paralysis.

RESULTS

At the end of 3 months follow-up 8 patients (80%) had successful outcome with no further episodes of dislocation, whereas two patients reported with recurrence. Post-operative MRI showed significant improvement after ABI, compared to pre-operative MRI. There were no degenerative changes to the bony and soft tissue components of TMJ.

CONCLUSIONS

ABI is a simple, safe, minimally invasive and cost-effective technique for treatment of chronic recurrent TMJ dislocation. MRI evaluation showed an improvement in the anatomical and spatial relationship of the osseous and soft tissue components of the TMJ. TMJ lavage, luxation, fibrosis, magnetic resonance imaging.

摘要

背景

本研究旨在评估关节穿刺并向关节间隙注射自体血(ABI)治疗慢性复发性颞下颌关节脱位的功能结果和MRI表现。

材料与方法

本研究共纳入10例双侧慢性复发性髁突脱位患者。对每位患者的双侧颞下颌关节进行关节穿刺,然后向上关节腔注射2 ml自体血,向关节囊外表面注射1 ml。术前和术后评估包括:详细病史、颞下颌关节临床检查、最大开口度、脱位频率、颞下颌关节X线片(开口和闭口位)、MRI、复发情况及面神经麻痹情况。

结果

在3个月随访结束时,8例患者(80%)取得成功结果,无进一步脱位发作,而2例患者出现复发。与术前MRI相比,术后MRI显示ABI后有显著改善。颞下颌关节的骨和软组织成分无退行性改变。

结论

ABI是一种治疗慢性复发性颞下颌关节脱位的简单、安全、微创且经济有效的技术。MRI评估显示颞下颌关节骨和软组织成分的解剖及空间关系有所改善。颞下颌关节灌洗、脱位、纤维化、磁共振成像。

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本文引用的文献

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Temporomandibular joint dislocation.颞下颌关节脱位
Oral Maxillofac Surg Clin North Am. 2015 Feb;27(1):125-36. doi: 10.1016/j.coms.2014.09.009.
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J Craniomaxillofac Surg. 2014 Oct;42(7):1486-90. doi: 10.1016/j.jcms.2014.04.018. Epub 2014 May 2.
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Arthrocentesis followed by intra-articular autologous blood injection for the treatment of recurrent temporomandibular joint dislocation.
颞下颌关节腔内注射的当前临床研究方向:一项图谱综述
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Arthrocentesis Followed by Autologous Blood Injection in the Treatment of Chronic Symptomatic Subluxation of Temporomandibular Joint.关节穿刺术联合自体血注射治疗颞下颌关节慢性症状性半脱位
J Maxillofac Oral Surg. 2022 Dec;21(4):1218-1226. doi: 10.1007/s12663-021-01540-1. Epub 2021 Apr 11.
关节穿刺术联合关节腔内自体血注射治疗复发性颞下颌关节脱位
Int J Oral Maxillofac Surg. 2014 Oct;43(10):1224-8. doi: 10.1016/j.ijom.2014.05.004. Epub 2014 Jun 17.
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Investigation of an autologous blood treatment strategy for temporomandibular joint hypermobility in a pig model.探讨一种用于猪模型颞下颌关节过度活动的自体血治疗策略。
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Autologous blood injection to the temporomandibular joint: magnetic resonance imaging findings.颞下颌关节自体血注射:磁共振成像结果
Imaging Sci Dent. 2012 Mar;42(1):13-8. doi: 10.5624/isd.2012.42.1.13. Epub 2012 Mar 22.
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Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation.评价颞下颌关节脱位的机制和管理原则。文献系统回顾与颞下颌关节脱位新分类建议。
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J Oral Maxillofac Surg. 2009 Jan;67(1):114-9. doi: 10.1016/j.joms.2008.08.044.