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在磨牙症患者中,关节穿刺术联合透明质酸是否优于单纯关节穿刺术治疗未复位的盘移位?

Is arthrocentesis plus hyaluronic acid superior to arthrocentesis alone in the treatment of disc displacement without reduction in patients with bruxism?

机构信息

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

出版信息

J Craniomaxillofac Surg. 2020 Nov;48(11):1023-1027. doi: 10.1016/j.jcms.2020.07.008. Epub 2020 Jul 25.

Abstract

PURPOSE

This study was designed to investigate the efficacy of arthrocentesis with and without intra-articular injection of hyaluronic acid (HA) in the treatment of disc displacement without reduction (DDwoR) in patients with bruxism.

MATERIALS AND METHODS

A retrospective cohort study was conducted using the files of patients with DDwoR, limited mouth opening, and bruxism. Patients were divided into two groups according to the treatment method: arthrocentesis alone (group 1) and arthrocentesis plus intra-articular HA injection (group 2). To evaluate the clinical outcomes for the groups, maximum mouth opening (MMO) and visual analog scale (VAS) values before treatment, immediately after the operation, and at 1, 3, 6, 9, and 12 months postoperatively were analyzed.

RESULTS

The study consisted of 40 patients (34 female and 6 male, mean age 36.0 ± 11.95 years). MMO values increased and VAS scores decreased in both groups at all follow-ups after the treatment compared with pretreatment values (p < 0.001). The increase in MMO in group 2 was greater than in group 1 only at 3 and 6 months postoperatively (p = 0.013 and 0.009, respectively).

CONCLUSIONS

Intra-articular HA injection is not a relevant addition when arthrocentesis is performed and a stabilizing splint is used.

摘要

目的

本研究旨在探讨关节内注射透明质酸(HA)联合与不联合关节内穿刺抽吸术治疗磨牙症伴不可复性盘前移位(DDwoR)的疗效。

材料和方法

采用回顾性队列研究,使用 DDwoR、开口受限和磨牙症患者的档案。根据治疗方法将患者分为两组:单纯关节内穿刺抽吸术(1 组)和关节内穿刺抽吸术联合关节内 HA 注射(2 组)。为评估两组的临床疗效,分析治疗前、术后即刻、术后 1、3、6、9 和 12 个月时的最大开口度(MMO)和视觉模拟评分(VAS)值。

结果

本研究共纳入 40 例患者(34 名女性和 6 名男性,平均年龄 36.0±11.95 岁)。与治疗前相比,两组在所有随访时的 MMO 值增加,VAS 评分降低(p<0.001)。与 1 组相比,2 组在术后 3 个月和 6 个月时 MMO 的增加更为显著(p=0.013 和 0.009)。

结论

当进行关节内穿刺抽吸术并使用稳定夹板时,关节内注射 HA 并不是一种相关的附加治疗方法。

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