Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai, China.
Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Int J Oral Maxillofac Surg. 2019 Jun;48(6):769-778. doi: 10.1016/j.ijom.2018.12.003. Epub 2018 Dec 26.
Disc displacement is a common disorder affecting the temporomandibular joint. According to previous publications, the displaced disc can be categorized into pure anterior displacement and rotational displacement (anteromedial and anterolateral). However, the technique of arthroscopy treatment has only been reported for patients with pure anterior disc displacement. In this study, an arthroscopic discopexy for rotational anterior disc displacement was developed and its effectiveness evaluated over 24 months of follow-up. A total of 532 patients (749 joints) with rotational anterior disc displacement, admitted to Shanghai Ninth People's Hospital between January 2011 and December 2015, were included. The success rate was based on clinical parameters (visual analogue scale (VAS) for pain, maximum inter-incisal opening (MIO), and complications) and radiographic data. The clinical and radiographic data were collected preoperatively and at 1, 6, 12, and 24months postoperative. The VAS score decreased to 0.73±1.43 following surgery (P<0.001). A significant improvement in MIO (34.73±6.28mm) was also detected (P<0.001). Magnetic resonance imaging showed discs repositioned in both sagittal and coronal images for 714 of the 749 joints, giving a success rate of 95.3%. This study reports an effective and predictable technique of arthroscopic discopexy for rotational anterior disc displacement.
关节盘前移位是一种常见的颞下颌关节紊乱疾病。根据以往的文献报道，可将移位的关节盘分为单纯前移位和（前内、前外）旋转移位。然而，关节镜治疗技术仅适用于单纯前移位的关节盘患者。本研究提出了一种用于治疗旋转性前移位关节盘的关节镜下盘复位术，并对其 24 个月的随访效果进行了评估。2011 年 1 月至 2015 年 12 月，上海第九人民医院共收治了 532 例（749 个关节）旋转性前移位关节盘患者。成功率的评估基于临床参数（疼痛的视觉模拟评分（VAS）、最大开口度（MIO）和并发症）和影像学数据。在术前、术后 1、6、12 和 24 个月时收集了临床和影像学数据。术后 VAS 评分降至 0.73±1.43（P<0.001）。MIO 也有显著改善（34.73±6.28mm）（P<0.001）。磁共振成像显示 749 个关节中有 714 个关节盘在矢状面和冠状面图像中重新定位，成功率为 95.3%。本研究报道了一种用于治疗旋转性前移位关节盘的有效且可预测的关节镜下盘复位术。
