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关节镜检查结果与颞下颌关节功能紊乱的临床-放射学征象和症状的相关性:829 个关节的回顾性研究。

Correlation of arthroscopic findings with clinical-radiological signs and symptoms of temporomandibular joint dysfunction: retrospective study of 829 joints.

机构信息

Department of Oral and Maxillofacial Surgery, Hospital Clínico San Carlos, Madrid, Spain.

Department of Oral and Maxillofacial Surgery, Hospital Clínico San Carlos, Madrid, Spain.

出版信息

Int J Oral Maxillofac Surg. 2022 Aug;51(8):1069-1073. doi: 10.1016/j.ijom.2022.01.010. Epub 2022 Feb 1.

DOI:10.1016/j.ijom.2022.01.010
PMID:35115221
Abstract

Temporomandibular joint (TMJ) arthroscopic findings are difficult to predict based on clinical criteria. Few studies have attempted to correlate signs, symptoms, and characteristics of patients with the final arthroscopic findings. The aim of this study was to assess the correlation between clinical-radiological signs and symptoms and arthroscopic findings in patients with TMJ dysfunction undergoing arthroscopy. A retrospective study was performed involving 487 patients (829 joints) with TMJ dysfunction who underwent TMJ arthroscopy between 2000 and 2019. The clinical-radiological variables recorded were pain, maximum mouth opening, joint noises, Wilkes classification, and disc displacement. The arthroscopic findings evaluated were synovitis, chondromalacia, adhesions, disc perforation, disc displacement, and roofing. Pain symptoms were significantly associated with the intensity of synovitis (P = 0.005) and disc displacement evaluated arthroscopically (P < 0.001). A statistically significant relationship was observed between Wilkes stage and the level of synovitis (P < 0.001) and chondromalacia (P < 0.001). Mouth opening was negatively correlated with adhesions (P < 0.001). Based on this study, pain symptomatology was associated with the intensity of synovitis and disc displacement evaluated arthroscopically, the Wilkes stage was a good predictor of the severity of synovitis and chondromalacia, and mouth opening was negatively correlated with adhesions.

摘要

颞下颌关节(TMJ)关节镜检查结果很难根据临床标准预测。很少有研究试图将患者的体征、症状和特征与最终的关节镜检查结果相关联。本研究旨在评估 TMJ 功能障碍患者的临床-影像学体征、症状与关节镜检查结果之间的相关性。对 2000 年至 2019 年间接受 TMJ 关节镜检查的 487 例(829 个关节)TMJ 功能障碍患者进行了回顾性研究。记录的临床-影像学变量包括疼痛、最大张口度、关节弹响、Wilkes 分类和盘移位。评估的关节镜检查结果包括滑膜炎、软骨软化、粘连、盘穿孔、盘移位和盘覆盖。疼痛症状与滑膜炎的严重程度(P = 0.005)和关节镜评估的盘移位(P < 0.001)显著相关。Wilkes 分期与滑膜炎(P < 0.001)和软骨软化(P < 0.001)的严重程度呈统计学显著相关。张口度与粘连呈负相关(P < 0.001)。基于这项研究,疼痛症状与滑膜炎和关节镜评估的盘移位的严重程度相关,Wilkes 分期是滑膜炎和软骨软化严重程度的良好预测指标,张口度与粘连呈负相关。

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