Bas Burcu, Kazan Dilara, Kutuk Nukhet, Gurbanov Vugar
Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey.
Research Assistant, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey.
J Oral Maxillofac Surg. 2018 Jun;76(6):1181-1186. doi: 10.1016/j.joms.2018.01.003. Epub 2018 Jan 12.
Arthrocentesis is an effective treatment modality for temporomandibular disorders, especially in patients who have pain and limited mouth opening. Surgeons generally suggest physical exercises after arthrocentesis and arthroscopy procedures; however, there has been no study in the literature evaluating the effects of exercise on clinical outcomes. This study investigated whether physical exercises after arthrocentesis would result in early improvements in clinical symptoms in patients with temporomandibular joint disc displacement without reduction (TMJ DDw/oR).
The study group was composed of 27 patients with TMJ DDw/oR. Patients who needed arthrocentesis after failed conservative nonsurgical treatment were enrolled in the study. Group 1 was composed of 14 patients who were not started on a physiotherapy program after the arthrocentesis procedure. Group 2 was composed of 13 patients who were started on a self-administered physiotherapy program immediately after the arthrocentesis procedure. Physiotherapy included a 6-week exercise program. Patients were followed for 3 months. Range of maximal mouth opening (MMO) and joint pain as measured by the visual analog scale (VAS) were examined to determine clinical efficacy before and after treatment.
In groups 1 and 2, mouth opening increased and pain scores decreased at 1-week and 1- and 3-month follow-ups (P < .05). No relevant relation was found between the 2 groups according to MMO for all time points and VAS scores at 1 week. A relevant relation was found between the 2 groups according to VAS scores at 1 and 3 months.
Physical exercise after arthrocentesis has no effect on range of mouth opening but does decrease pain.
关节穿刺术是治疗颞下颌关节紊乱病的一种有效方法，尤其适用于有疼痛和张口受限的患者。外科医生通常建议在关节穿刺术和关节镜检查术后进行体育锻炼；然而，文献中尚无研究评估锻炼对临床结果的影响。本研究调查了关节穿刺术后体育锻炼是否能使颞下颌关节盘不可复性移位（TMJ DDw/oR）患者的临床症状得到早期改善。
研究组由27例TMJ DDw/oR患者组成。经保守非手术治疗失败后需要进行关节穿刺术的患者纳入本研究。第1组由14例在关节穿刺术后未开始物理治疗计划的患者组成。第2组由13例在关节穿刺术后立即开始自我管理物理治疗计划的患者组成。物理治疗包括一个为期6周的锻炼计划。对患者进行3个月的随访。在治疗前后检查最大张口度（MMO）范围和用视觉模拟量表（VAS）测量的关节疼痛，以确定临床疗效。
在第1组和第2组中，在1周以及1个月和3个月随访时，张口度增加，疼痛评分降低（P < 0.05）。在所有时间点，根据MMO以及在1周时的VAS评分，两组之间未发现相关性。根据1个月和3个月时的VAS评分，两组之间发现了相关性。
关节穿刺术后体育锻炼对张口度范围没有影响，但确实能减轻疼痛。
