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复发性颞下颌关节脱位的手术治疗——一项系统评价

Surgical management of recurrent TMJ dislocation-a systematic review.

作者信息

Tocaciu Shreya, McCullough M J, Dimitroulis G

机构信息

Oral and Maxillofacial Unit, St Vincent's Hospital Melbourne, Fitzroy, Australia.

Oral Medicine Unit, Melbourne Dental School, University of Melbourne, Melbourne, Australia.

出版信息

Oral Maxillofac Surg. 2019 Mar;23(1):35-45. doi: 10.1007/s10006-019-00746-5. Epub 2019 Feb 7.

Abstract

PURPOSE

Recurrent temporomandibular joint (TMJ) dislocation can be challenging to treat and the current understanding regarding aetiology and management of this condition is limited. The aim of this paper was to conduct a systematic review regarding the management of recurrent TMJ dislocation.

METHODS

A literature review was conducted using PRISMA guidelines to identify papers published between 2006 and 2016. The resultant papers were analysed.

RESULTS

A total of 33 papers were found relevant to the study. Minimally invasive techniques described included autologous blood injection, which was associated with an overall success of 80% at 12 months. Other modalities investigated included OK-432 sclerotherapy, laser capsulorrhaphy, botulinum toxin of the lateral pterygoid muscle or modified dextrose. These publications show promising success rates. Surgical techniques described included disc plication, eminoplasty and eminectomy. These modalities had a similar success rate, although numbers were limited. The true incidence of recurrent TMJ dislocation is unknown and aetiology is limited to expert opinion.

CONCLUSION

The current understanding of management for recurrent TMJ dislocation is limited to case series and case reports. This paper compiles the current understanding of management of recurrent TMJ dislocation. Compared to previous reviews, this paper describes some novel minimally invasive techniques with promising success in the management of recurrent TMJ dislocation.

摘要

目的

复发性颞下颌关节(TMJ)脱位的治疗具有挑战性,目前对该病症病因及治疗的认识有限。本文旨在对复发性TMJ脱位的治疗进行系统综述。

方法

采用PRISMA指南进行文献综述,以确定2006年至2016年间发表的论文。对所得论文进行分析。

结果

共发现33篇与该研究相关的论文。所描述的微创技术包括自体血注射,12个月时总体成功率为80%。研究的其他方法包括OK-432硬化疗法、激光关节囊缝合术、翼外肌肉毒杆菌毒素或改良葡萄糖。这些出版物显示出有希望的成功率。所描述的手术技术包括盘折叠术、髁突成形术和髁突切除术。尽管病例数量有限,但这些方法的成功率相似。复发性TMJ脱位的真实发病率未知,病因仅基于专家意见。

结论

目前对复发性TMJ脱位治疗的认识仅限于病例系列和病例报告。本文汇总了目前对复发性TMJ脱位治疗的认识。与以往的综述相比,本文描述了一些在复发性TMJ脱位治疗中取得有希望成功的新型微创技术。

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