Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Beijing, 100081, P. R. China.
Department of Oral and Maxillofacial Surgery, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin, 300041, P. R. China.
Sci Rep. 2019 Jul 19;9(1):10493. doi: 10.1038/s41598-019-46519-8.
This study aimed to describe the clinical features of different types of traumatic temporomandibular joint (TMJ) ankylosis. Seventy-one patients with 102 ankylosed joints were retrospectively reviewed and categorized into four groups according to the grades of severity: type I, non-bony ankylosis of the joint with almost-normal joint space; type II, lateral bony ankylosis marked by a normal joint space that coexists with a radiolucent line; type III, complete bony ankylosis of the joint characterized by only a radiolucent line; and type IV, extensive bony ankylosis without any radiolucent line. The period of ankylosis, maximal mouth opening (MMO), rate of complications, and histopathological changes were compared among groups. Intergroup comparison showed significant differences in the clinical features of MMO and the incidence of complications (p < 0.05). Younger trauma patients tended to develop more severe types of ankylosis than older patients. Additionally, long post-trauma periods were related to the development of severe ankylosis. MMO was highly negatively correlated with the severity of ankylosis. Significant differences were noted among the four types of ankylosis. Younger trauma patients with long post-trauma periods tended to develop more severe TMJ ankylosis, experience more complications, and face more challenges in treatment than older patients.
本研究旨在描述不同类型创伤性颞下颌关节(TMJ)强直的临床特征。回顾性分析了 71 例 102 例强直关节患者,根据严重程度分为 4 组:Ⅰ型,关节无骨强直,关节间隙基本正常;Ⅱ型,关节外侧骨强直,关节间隙正常,伴透亮线;Ⅲ型,关节完全骨强直,仅透亮线;Ⅳ型,广泛骨强直,无透亮线。比较各组的强直时间、最大张口度(MMO)、并发症发生率和组织病理学变化。组间比较显示 MMO 和并发症发生率的临床特征有显著差异(p<0.05)。年轻创伤患者比老年患者更容易发生更严重类型的强直。此外,外伤后时间较长与严重强直的发生有关。MMO 与强直的严重程度呈高度负相关。4 种强直类型之间存在显著差异。年轻、外伤后时间较长的患者比老年患者更容易发生更严重的 TMJ 强直,更易发生并发症,治疗更具挑战性。