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功能性正畸治疗后下颌髁突重塑:4例临床报告

Mandibular Condyle Remodeling after Functional Orthopedic Treatment: A Clinical Report of Four Cases.

作者信息

Aube Alain, Ramirez-Yanez German O

机构信息

Private Practice, Institut Canadien d'Occlusion Montreal, Quebec, Canada.

Private Practice, Aurora Kids Dentistry, Aurora, Ontario, Canada, Phone: +1 647 963 5716, e-mail:

出版信息

J Contemp Dent Pract. 2019 Dec 1;20(12):1461-1465.

Abstract

AIM

This clinical report evaluated changes in the mandibular condyles of patients diagnosed with osteoarthritis (OA) at the temporomandibular joint (TMJ), who were treated with a modified dental splint.

MATERIALS AND METHODS

Four adult patients (age range: 24-47 years) were treated with a dental splint appliance that delivered a low load at the molar region and permitted lateral and protrusive mandibular excursions. An initial magnetic resonance imaging (MRI) scan was performed for diagnosis purpose before treatment. A second MRI scan was conducted after 12 months of treatment to evaluate changes at the TMJ.

RESULTS

The observations from the MRI results in the four patients showed positive changes at the end of the study period. The results presented here suggest the treatment provided significantly reduced the forces damaging the tissues covering the surface of the mandibular condyle, such as cartilage and cortical bone, which may be the cause of the OA. In that context, it is suggested that that reduction in the overloading of the TMJ produced by the functional dental splint permitted the recovery of those tissues.

CONCLUSION

The present results support the idea that the tissues composing the TMJ are viable and may respond to positive stimulus. In that way, this report proposes a way to treat those patients with TMJ OA, who may respond when the treatment aims to reduce the overloading forces affecting the TMJ.

CLINICAL SIGNIFICANCE

This report proposes a noninvasive clinical treatment for patients with TMJ OA, who may respond when the treatment aims to reduce the overloading forces affecting the TMJ.

摘要

目的

本临床报告评估了使用改良牙合板治疗的颞下颌关节(TMJ)骨关节炎(OA)患者下颌髁突的变化。

材料与方法

4名成年患者(年龄范围:24 - 47岁)接受了一种牙合板矫治器治疗,该矫治器在磨牙区施加低负荷,并允许下颌进行侧向和前伸运动。治疗前进行了首次磁共振成像(MRI)扫描以用于诊断。治疗12个月后进行了第二次MRI扫描以评估TMJ的变化。

结果

4名患者的MRI结果显示在研究期末出现了积极变化。此处呈现的结果表明,该治疗显著降低了损伤覆盖下颌髁突表面组织(如软骨和皮质骨)的力量,而这些组织可能是OA的病因。在此背景下,提示功能性牙合板减少了TMJ的超负荷,从而使这些组织得以恢复。

结论

目前的结果支持这样一种观点,即构成TMJ的组织具有活力,并且可能对积极刺激做出反应。通过这种方式,本报告提出了一种治疗TMJ OA患者的方法,当治疗旨在减少影响TMJ的超负荷力量时,这些患者可能会有反应。

临床意义

本报告为TMJ OA患者提出了一种非侵入性临床治疗方法,当治疗旨在减少影响TMJ的超负荷力量时,这些患者可能会有反应。

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