Zatarain Lauren A, Smith Derek K, Deng Jie, Gilbert Jill, Dietrich Mary S, Niermann Kenneth J, Ridner Sheila H, Murphy Barbara A
1 Our Lady of the Lake Physician Group, Baton Rouge, LA, USA.
2 Vanderbilt University Medical Center, Nashville, TN, USA.
Integr Cancer Ther. 2018 Sep;17(3):960-967. doi: 10.1177/1534735418784363. Epub 2018 Jun 28.
This study was designed to assess the feasibility of using the Jaw Dynasplint System as an adjunct to conventional stretching exercises as a preventative measure against trismus in patients undergoing radiotherapy.
Study participants (n = 40) were randomized using a permuted block design to conventional stretching or stretching plus use of the Jaw Dynasplint 3 times per day for 30 minutes. Patients were instructed to record maximum interincisal opening each day as well as logging use of the Jaw Dynasplint.
At 6 months after initiation of the preventative regimen, 50% of patients in the Dynasplint arm and 75% in the conventional stretching arm remained on their assigned therapy. Trismus was diagnosed in 2 patients in the control arm and in 4 patients in the Dynasplint arm. Only 25% (95% confidence interval = 11.1, 46.9) of patients in the Dynasplint arm used the device as prescribed.
The addition of the Jaw Dynasplint decreased compliance compared with conventional stretching. It is unlikely that the prescribed regimen will prove efficacious as a preventative measure due to low compliance.
本研究旨在评估使用颌动力夹板系统作为常规伸展运动的辅助手段，对接受放射治疗的患者预防牙关紧闭的可行性。
研究参与者（n = 40）采用置换区组设计随机分为常规伸展组或伸展加每天使用颌动力夹板3次、每次30分钟组。指导患者每天记录最大切牙间开口度，并记录颌动力夹板的使用情况。
在预防性治疗方案开始6个月后，动力夹板组50%的患者和常规伸展组75%的患者仍在接受指定治疗。对照组有2例患者被诊断为牙关紧闭，动力夹板组有4例。动力夹板组只有25%（95%置信区间 = 11.1, 46.9）的患者按规定使用该装置。
与常规伸展相比，添加颌动力夹板降低了依从性。由于依从性低，规定的治疗方案作为预防措施不太可能有效。
