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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.

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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