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颞下颌关节强直的复发相关因素:十年经验

Recurrence-Related Factors of Temporomandibular Joint Ankylosis: A 10-Year Experience.

作者信息

Chen Shuo, He Yang, An Jin-Gang, Zhang Yi

机构信息

Attending, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology; and National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China.

Assistant Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology; and National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China.

出版信息

J Oral Maxillofac Surg. 2019 Dec;77(12):2512-2521. doi: 10.1016/j.joms.2019.06.172. Epub 2019 Jul 2.

Abstract

PURPOSE

The treatment of temporomandibular joint (TMJ) ankylosis can be challenging for surgeons because of technical difficulties and a high incidence of recurrence. In the present study, we reviewed the data from patients with TMJ ankylosis during a 10-year period and explored the risk factors for recurrence.

MATERIALS AND METHODS

A retrospective cohort study was conducted to review the data from patients with TMJ ankylosis from January 1, 2006 to December 31, 2015. The predictor variables were age, TMJ ankylosis classification, and treatment method. The primary outcome variable was the recurrence rate of TMJ ankylosis during follow-up. The χ test or Fisher exact test was performed to analyze the differences in the recurrence rate.

RESULTS

A total of 130 patients (59 females and 71 males; age, 3 to 67 years) were included in the present study. All the patients were divided into 3 groups according to their age. The rate of joint reankylosis among the children was 19.1%, which was significantly greater than that of the adults (7.3%; P < .05). In the adults, the joint was reconstructed using a coronoid process graft (CPG), distraction osteogenesis, or prosthesis implantation for type III. Among these treatments, CPG resulted in the greatest recurrence rate (26.7%).

CONCLUSIONS

Children with ankylosis were found to be more prone to recurrence compared with adults. TMJ ankylosis was also more likely to recur in adults undergoing reconstruction with a CPG.

摘要

目的

由于技术难题和高复发率,颞下颌关节(TMJ)强直的治疗对外科医生而言颇具挑战性。在本研究中,我们回顾了10年间TMJ强直患者的数据,并探究了复发的危险因素。

材料与方法

开展一项回顾性队列研究,以回顾2006年1月1日至2015年12月31日期间TMJ强直患者的数据。预测变量为年龄、TMJ强直分类及治疗方法。主要结局变量为随访期间TMJ强直的复发率。采用χ检验或Fisher精确检验分析复发率的差异。

结果

本研究共纳入130例患者(59例女性和71例男性;年龄3至67岁)。所有患者根据年龄分为3组。儿童关节再次强直的发生率为19.1%,显著高于成人(7.3%;P <.05)。在成人中,对于III型患者采用喙突移植(CPG)、牵张成骨或假体植入进行关节重建。在这些治疗方法中,CPG导致的复发率最高(26.7%)。

结论

与成人相比,强直患儿更易复发。接受CPG重建的成人TMJ强直也更易复发。

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