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人羊膜在颞下颌关节退行性疾病手术治疗中的定位

Human Amniotic Membrane Positioning in the Surgical Treatment of Temporomandibular Joint Degenerative Disorder.

作者信息

Guarda-Nardini Luca, Trojan Diletta, Montagner Giulia, Cogliati Elisa, Bendini Matteo, Manfredini Daniele

机构信息

Section of Dentistry and Maxillofacial Surgery, Treviso Hospital, Treviso, Italy.

Treviso Tissue Bank Foundation, Treviso, Italy.

出版信息

Case Rep Surg. 2019 Mar 3;2019:6037191. doi: 10.1155/2019/6037191. eCollection 2019.

Abstract

BACKGROUND

Temporomandibular joint (TMJ) arthritis is a degenerative pathology that may cause pain and dysfunction. Nonsurgical therapy is the traditional treatment of TMJ diseases but if ineffective, TMJ surgery can be performed and may include arthroplasty with interposition of autograft. The encouraging results reported with the use of human amniotic membrane (HAM) in different surgical fields have highlighted its potential, but approaches providing the positioning of HAM within the intra-articular space of arthritic TMJs have never been investigated.

CASE PRESENTATION

A 48-year-old woman was presented with limited mouth opening and pain with palpation at the left joint. A severe TMJ degeneration was diagnosed, and a surgical treatment was necessary. In the present case report, the authors describe the application of a cryopreserved HAM patch within the joint space as a disc-replacing film during major surgeries for discectomy and arthroplasty. Three months after the intervention, the patient reported an overall improvement in chewing efficiency as well as the absence of pain.

CONCLUSIONS

According to the regenerative effects of HAM, the design of trials on the topic should be encouraged for its possible inclusion within the field of TMJ disease practice.

摘要

背景

颞下颌关节(TMJ)关节炎是一种退行性病变,可能导致疼痛和功能障碍。非手术治疗是TMJ疾病的传统治疗方法,但如果无效,可以进行TMJ手术,可能包括自体移植插入的关节成形术。在不同手术领域使用人羊膜(HAM)报告的令人鼓舞的结果突出了其潜力,但从未研究过将HAM定位在关节炎性TMJ关节内空间的方法。

病例报告

一名48岁女性出现张口受限和左侧关节触痛。诊断为严重的TMJ退变,需要进行手术治疗。在本病例报告中,作者描述了在椎间盘切除术和关节成形术等大手术中,将冷冻保存的HAM贴片作为椎间盘替代膜应用于关节间隙。干预三个月后,患者报告咀嚼效率总体提高,且无疼痛。

结论

根据HAM的再生作用,应鼓励开展该主题的试验设计,因为它可能被纳入TMJ疾病实践领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d73c/6421772/717ee5a6b298/CRIS2019-6037191.001.jpg

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