Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Al Azhar University, Cairo, Egypt.
Faculty of Medicine for Men, Al Azher University, Cairo, Egypt.
Sci Rep. 2021 Oct 22;11(1):20917. doi: 10.1038/s41598-021-00456-7.
This prospective clinical study aimed to establish a new classification system for TMJ internal derangement based on MRI in correlation with clinical findings contributing to a nonsurgical treatment protocol. A consecutive sample of 435 internal derangement patients was enrolled in the study. Clinical and MRI studies were used to establish the new classification system. A total of 747 joints were classified according to our staging system and received treatment according to the associated nonsurgical treatment protocol. The primary outcome variables were maximum voluntary mouth opening and visual analogue scale pain scores. The secondary outcome variable was joint sound. Statistical analysis of the differences between pretreatment and posttreatment measurements showed an increase in mouth opening throughout the study period (P < 0.001 at 12 m posttreatment). Statistical analysis of the VAS scores showed a statistically significant decrease in all study groups during all study periods, with P < 0.0001 at 12 months posttreatment. Statistical analysis of joint sounds showed significant improvement during all study periods. The new classification system is a simple, & reasonable including a detailed description of all the pathologic changes of the joint. The nonsurgical treatment protocol was Simple, effective and specific depending on the pathological changes in joint.
本前瞻性临床研究旨在建立一种新的基于 MRI 的 TMJ 内部紊乱分类系统，与有助于非手术治疗方案的临床发现相关联。本研究纳入了连续的 435 例内部紊乱患者。临床和 MRI 研究用于建立新的分类系统。根据我们的分期系统对总共 747 个关节进行分类，并根据相关的非手术治疗方案进行治疗。主要的结果变量是最大自主开口度和视觉模拟评分疼痛。次要结果变量是关节音。治疗前和治疗后测量值之间的差异的统计分析显示，整个研究期间开口度增加（治疗后 12 个月时 P<0.001）。VAS 评分的统计分析显示，所有研究组在所有研究期间均呈统计学显著下降，治疗后 12 个月时 P<0.0001。关节音的统计分析显示，所有研究期间均有显著改善。新的分类系统简单合理，包括对关节所有病理变化的详细描述。根据关节的病理变化，非手术治疗方案简单、有效且具有特异性。
