Division of Maxillofacial Surgery, Department of Otolaryngology, Hospital de San José, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia.
Department of Otolaryngology, Hospital de San José, Fundación Universitaria de Ciencias de la Salud, Cl. 10 #18-75, Bogotá, Colombia.
J Stomatol Oral Maxillofac Surg. 2018 Feb;119(1):16-18. doi: 10.1016/j.jormas.2017.10.008. Epub 2017 Oct 10.
Temporomandibular joint internal derangement is a common disorder, which usually resolves with conservative management. However, 5% of patients require surgery and although many techniques have been described, a gold standard surgical procedure has not yet been established.
The aim of this study was to compare the clinical outcome of disc repositioning plus temporal eminectomy versus disc repositioning alone, for the treatment of temporomandibular joint internal derangement.
Matched case-control retrospective pilot study. Records of patients diagnosed with temporomandibular joint internal derangement from January 2010 to December 2015 were studied. Eleven patients treated with disc repositioning plus temporal eminectomy for the case group and 11 patients treated with disc repositioning alone for the age- and gender-matched control group.
No difference was found in terms of pain, noise or blockage with the maximum oral opening between the groups at the first or sixth month after surgery. However, there were differences in movement restriction at the first and sixth month after surgery, in favor of the temporal eminectomy group. These differences were statistically significant only at the sixth month after surgery (P: 0.03).
Our results suggest that disc repositioning plus temporal eminectomy could be a short-term benefit in terms of mobility and oral opening. However, larger samples and prospective trials will be necessary to corroborate the current findings.
颞下颌关节紊乱是一种常见疾病,通常采用保守治疗即可痊愈。然而,仍有 5%的患者需要手术治疗,尽管已经描述了许多技术,但尚未确立金标准的手术程序。
本研究旨在比较盘复位联合颞骨切除术与单纯盘复位治疗颞下颌关节紊乱的临床效果。
匹配的病例对照回顾性试点研究。研究了 2010 年 1 月至 2015 年 12 月期间诊断为颞下颌关节紊乱的患者的记录。将 11 例接受盘复位联合颞骨切除术治疗的患者设为病例组,将 11 例接受单纯盘复位治疗的患者按年龄和性别匹配为对照组。
在术后第 1 个月和第 6 个月,两组的最大张口度、疼痛、噪音或阻滞方面无差异。然而,在术后第 1 个月和第 6 个月,运动受限方面存在差异,颞骨切除术组更为有利。这些差异仅在术后第 6 个月具有统计学意义(P:0.03)。
我们的结果表明,盘复位联合颞骨切除术在改善关节活动度和张口度方面可能具有短期优势。然而,需要更大的样本量和前瞻性试验来证实目前的发现。