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评价改良锚钉在颞下颌关节盘复位手术中的应用:25 例患者的前瞻性研究。

Evaluation of an improved anchoring nail in temporomandibular joint disc repositioning surgery: A prospective study of 25 patients.

机构信息

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.

出版信息

J Craniomaxillofac Surg. 2021 Oct;49(10):929-934. doi: 10.1016/j.jcms.2021.05.008. Epub 2021 Jun 3.

Abstract

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.

摘要

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。

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