Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, And Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China.
J Craniomaxillofac Surg. 2021 Oct;49(10):929-934. doi: 10.1016/j.jcms.2021.05.008. Epub 2021 Jun 3.
To confirm the effectiveness and stability of an improved anchoring nail through a prospective study using clinical evaluation and magnetic resonance imaging (MRI). Patients undergoing TMJ disc reduction and fixation were followed up for 1 year.Visual analog scale (VAS) pain scores and TMJ range of motion (maximum interincisal opening, protrusive excursion, lateral excursion) data were gathered pre- and postoperatively, and patient satisfaction was recorded. Four time points were investigated: before surgery (T0), 1 month post-surgery (T1), 6 months post-surgery (T2), and 1 year post-surgery (T3). Twenty-five patients (50 joints) participated in the study. The overall success rates of the improved and traditional anchoring nails were 88% and 92%, respectively. One year post-surgery, the patients' TMJ motion improved significantly (p < 0.001), and their pain was significantly alleviated (p < 0.001). Condyle height did not change significantly within 6 months (p = 0.801), but had increased by approximately 1.35 mm (p < 0.001) at 1 year post-surgery. The MRI scans also confirmed that new bone mass growth was present 1 year post-surgery. Compared with the traditional anchoring nail, the improved anchoring nail had a similar success rate and was associated with fewer foreign body sensations and less pain. Its clinical application should be further tested in studies with longer follow-up times and larger sample sizes.
通过前瞻性研究，使用临床评估和磁共振成像（MRI）来确认改良锚固钉的有效性和稳定性。对接受 TMJ 盘复位和固定的患者进行为期 1 年的随访。收集术前和术后视觉模拟评分（VAS）疼痛评分和 TMJ 运动范围（最大开口度、前伸度、侧方运动度）数据，并记录患者满意度。研究共调查了 4 个时间点：术前（T0）、术后 1 个月（T1）、术后 6 个月（T2）和术后 1 年（T3）。25 名患者（50 个关节）参与了研究。改良锚固钉和传统锚固钉的总体成功率分别为 88%和 92%。术后 1 年，患者的 TMJ 运动明显改善（p<0.001），疼痛明显缓解（p<0.001）。6 个月内髁突高度无明显变化（p=0.801），但术后 1 年增加了约 1.35mm（p<0.001）。MRI 扫描还证实术后 1 年有新的骨量生长。与传统锚固钉相比，改良锚固钉具有相似的成功率，异物感和疼痛较少。其临床应用应在随访时间更长、样本量更大的研究中进一步测试。
