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关节内注射富血小板纤维蛋白与透明质酸联合关节腔灌洗治疗颞下颌关节内部紊乱的疗效比较。

Comparison of the Efficiacy of Intra-Articular Injection of Liquid Platelet-Rich Fibrin and Hyaluronic Acid After in Conjunction With Arthrocentesis for the Treatment of Internal Temporomandibular Joint Derangements.

机构信息

Department of Oral and Maxillofacial Surgery, Istanbul Aydin University.

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Biruni University, Istanbul, Turkey.

出版信息

J Craniofac Surg. 2020 Oct;31(7):1870-1874. doi: 10.1097/SCS.0000000000006545.

Abstract

The aim of this study was to evaluate the effectiveness of intra-articular injection of liquid platelet-rich fibrin (I-PRF) versus hyaluronic acid (HA) following arthrocentesis in patients suffering from temporomandibular joint (TMJ) pain and dysfunction. A total of 69 patients with internal TMJ derangement were enrolled in this retrospective, matched cohort study. A total of 47 included patients (67 joints) were divided into 3 groups as follows: 16 participants in the arthrocentesis-only group; 14 patients in the arthrocentesis plus HA injection group (A+HA); and 17 participants in the arthrocentesis plus I-PRF injection group (A+I-PRF). The 2 outcome variables were TMJ pain and maximal mouth opening (MMO) which were evaluated up to 12 months postoperatively. The data were analyzed using the Shapiro-Wilk test, Kruskal-Wallis test, Mann-Whitney U test, Wilcoxon sign test, Fisher exact test, and the χ test. Statistically significant decreases in pain scores and increases in MMO values were observed in all 3 groups during the 12 months of follow-up. The significant decrease in pain values was shown in the A+I-PRF group as compared with the A+HA group at 9 months postoperatively. MMO values in the A+I-PRF group were significantly higher than in the A+HA group at 9 and 12 months postoperatively. All conventional treatment procedures can provide pain reduction and improvement to MMO. However, intraarticular injections of I-PRF in combination with arthrocentesis showed superior performance in terms of the gradual improvement in pain alleviation and range of mouth opening.

摘要

本研究旨在评估关节内注射富含血小板的纤维蛋白(I-PRF)与透明质酸(HA)在关节腔穿刺后治疗颞下颌关节(TMJ)疼痛和功能障碍患者的疗效。共有 69 例 TMJ 内部紊乱患者参与了这项回顾性、匹配队列研究。共有 47 例纳入患者(67 个关节)分为 3 组:关节腔穿刺组(16 例);关节腔穿刺联合 HA 注射组(A+HA,14 例);关节腔穿刺联合 I-PRF 注射组(A+I-PRF,17 例)。2 个观察结果变量为 TMJ 疼痛和最大张口度(MMO),术后随访 12 个月时进行评估。采用 Shapiro-Wilk 检验、Kruskal-Wallis 检验、Mann-Whitney U 检验、Wilcoxon 符号秩检验、Fisher 确切检验和 χ 检验对数据进行分析。在 12 个月的随访中,所有 3 组的疼痛评分均显著降低,MMO 值均显著增加。与 A+HA 组相比,A+I-PRF 组术后 9 个月疼痛值显著降低。术后 9 个月和 12 个月,A+I-PRF 组的 MMO 值明显高于 A+HA 组。所有常规治疗程序均可减轻疼痛并改善 MMO。然而,与关节腔穿刺术联合使用 I-PRF 的关节内注射在缓解疼痛和张口度逐渐改善方面表现出更好的性能。

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