Department of Conservative Dentistry and Bucofacial Prosthesis, Complutense University of Madrid, Pza. Ramón y Cajal, s/n, 28040, Madrid, Spain.
Department of Oral and Maxillofacial Surgery, Gregorio Marañón University General Hospital, Calle Dr. Esquerdo, 46, 28007, Madrid, Spain.
J Craniomaxillofac Surg. 2022 Jul;50(7):583-589. doi: 10.1016/j.jcms.2022.06.004. Epub 2022 Jun 17.
The purpose of the study was to assess the long-term oral health-related quality of life (oQoL) in patients with temporomandibular joint (TMJ) internal derangement (ID) after TMJ arthrocentesis plus hyaluronic acid (HA). Patients were analysed at different follow-up times using an analytical observational design. The Oral Health Impact Profile-14 (OHIP-14) score was evaluated according to age, sex, disc position, presence of degenerative joint disease (DJD), joint pain, maximum mouth opening and follow-up time. A total of 60 participants were enrolled, 88% female, with a mean age of 38 years (SD = 13.48). In an average follow-up of 25.02 months (SD = 5.32), the OHIP-14 total score decreased 8.67 (95% confidence interval [CI]: -11.21 to -6.11) after the intervention (Cohen's d = 1.22; 95% CI = 0.81 to 1.64). All OHIP-14 domain scores decreased (p < 0.05) except for the Functional limitation domain (p = 0.378). The oQoL after the intervention worsened in female patients (p = 0.039) and with a higher level of pain at baseline (p = 0.002). Self-perceived QoL improvement should be considered stable long term after temporomandibular joint arthrocentesis plus HA, regardless of concurrence with DJD or ID subtype. QoL should be used as clinical assessment measure of ID patients, with special attention to those with higher levels of pain.
本研究旨在评估 TMJ 关节内紊乱 (ID) 患者接受 TMJ 关节腔穿刺术加透明质酸 (HA) 治疗后的长期口腔健康相关生活质量 (oQoL)。采用分析性观察设计,在不同随访时间对患者进行分析。根据年龄、性别、关节盘位置、退行性关节病 (DJD) 存在情况、关节疼痛、最大张口度和随访时间,使用口腔健康影响量表 14 项 (OHIP-14) 评分进行评估。共纳入 60 名参与者,女性占 88%,平均年龄为 38 岁 (SD=13.48)。在平均 25.02 个月 (SD=5.32) 的随访中,干预后 OHIP-14 总分下降 8.67(95%置信区间 [CI]:-11.21 至-6.11)(Cohen's d=1.22;95% CI:0.81 至 1.64)。除功能障碍域外 (p=0.378),所有 OHIP-14 域评分均下降 (p<0.05)。干预后女性患者 (p=0.039) 和基线疼痛水平较高的患者 (p=0.002) 的 oQoL 恶化。TMJ 关节腔穿刺术加 HA 治疗后,无论 DJD 或 ID 亚型是否并存,自我感知的 QoL 改善应被认为是长期稳定的。QoL 应作为 ID 患者的临床评估指标,特别关注疼痛水平较高的患者。