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关节镜下锚钉固定治疗颞下颌关节盘内移位:临床和磁共振成像评估。

Arthroscopic discopexy technique with anchors for treatment of temporomandibular joint internal derangement: Clinical and magnetic resonance imaging evaluation.

机构信息

Oral and Maxillofacial Surgery Area, State University of São Paulo - UNESP, College of Dentistry, São José dos Campos, and Oral and Maxillofacial Surgeon, Hospital Geral de Vila Penteado, São Paulo, Brazil.

Department of Oral and Maxillofacial Surgery, Hospital Santana, Mogi das Cruzes, São Paulo, Brazil.

出版信息

J Craniomaxillofac Surg. 2020 May;48(5):501-507. doi: 10.1016/j.jcms.2020.03.003. Epub 2020 Mar 12.

Abstract

PURPOSE

The objective of this study was to describe a technique of arthroscopic discopexy with anchors used to treat temporomandibular joint internal derangement.

MATERIALS AND METHODS

This study involved patients with unilateral temporomandibular dysfunction refractory to conservative treatment, and whose magnetic resonance imaging (MRI) examinations showed internal derangement of the temporomandibular disc, with anterior disc displacement. Maximal interincisal opening (MIO), joint pain, joint noise, and disc position were the variables assessed by clinical examination and MRI before and 6 months after the surgery.

RESULTS

The sample consisted of 20 patients. In the postoperative evaluation, MIO had increased from 33.8 ± 4.83 mm to 35.1 ± 4.08 mm (p = 0.04), while joint pain had decreased from 7.5 ± 1.42 points to 2.05 ± 1.47 points (p = 0.001). With regard to joint noise, 19 of the patients had presented with clicking or crepitation but after 6 months these were completely absent. Disc repositioning was complete in 15 of the patients and partial in the other five.

CONCLUSION

The technique of arthroscopic discopexy with anchors was shown to be effective in treating temporomandibular internal derangement, with good clinical results.

摘要

目的

本研究旨在描述一种使用锚钉进行关节镜下盘固定术的技术,用于治疗颞下颌关节内部紊乱。

材料与方法

本研究纳入了单侧颞下颌功能障碍且对保守治疗无效的患者,其磁共振成像(MRI)检查显示为颞下颌盘内部紊乱,伴前盘移位。最大开口度(MIO)、关节疼痛、关节弹响和盘位置是通过临床检查和 MRI 在术前和术后 6 个月评估的变量。

结果

样本包括 20 名患者。术后评估显示,MIO 从 33.8±4.83mm 增加到 35.1±4.08mm(p=0.04),而关节疼痛从 7.5±1.42 分降至 2.05±1.47 分(p=0.001)。关于关节弹响,19 名患者有弹响或摩擦音,但术后 6 个月后完全消失。15 名患者的盘复位完全,5 名患者部分复位。

结论

关节镜下盘固定术治疗颞下颌关节内部紊乱是有效的,具有良好的临床效果。

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