Wang X R, Qiao Y M, Qiao Yiqiang
Department of Orthodontics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2022 Sep 9;57(9):914-920. doi: 10.3760/cma.j.cn112144-20220430-00232.
MRI images were used to study the efficacy of anterior repositioning splint (ARS) in the treatment of different types of disc displacement with reduction (DDWR) in temporomandibular joint. From September 2020 to December 2021, 26 patients with DDWR were enrolled in the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Zhengzhou University. There were 5 males and 21 females with an average age of (20.8±5.8) years. ARS was used for 3-6 months. The changes of joint clicking, opening type and joint pain before and after treatment were compared. The changes of disc position, disc-condyle angle and condylar bone mass before and after treatment were compared by MRI. Paired -test was performed on the disc-condyle angle before and after treatment, Fisher's exact test was performed on the change of disk position, and other count data were expressed as rate (%). After ARS treatment, the effective rates of joint clicking,abnormal opening, joint pain and disc displacement were 97%(35/36), 14/18, 7/9 and 95%(36/38). MRI analysis found that there was a significant difference between the disc position before and after treatment (<0.001), MRI analysis showed that the anterior disc displacement (48%, 25/52) and the anterolateral disc displacement (17%, 9/52) were the most common before treatment. In contrast, the normal superior disc (75%, 39/52) and the anterior disc displacement (17%, 9/52) were the most common after treatment, no significant changes were seen after treatment in the anteromedial disc displacement. The disc-condylar angle was (36.09±19.02) ° before ARS treatment and (3.94±10.12) ° after ARS treatment(=9.23, <0.001). After treatment, 46% (12/16) of the patients showed new bone formation, and the height of the condyle recovered. The clinical efficacy of ARS in the treatment of anterior disc displacement and anterolateral displacement of temporomandibular joint is remarkable, which can restore the disc-condylar relationship of most patients with indications.
采用磁共振成像（MRI）图像研究前伸复位夹板（ARS）治疗颞下颌关节不同类型可复性盘前移位（DDWR）的疗效。2020年9月至2021年12月，郑州大学第一附属医院口腔颌面外科收治26例DDWR患者。其中男性5例，女性21例，平均年龄（20.8±5.8）岁。使用ARS治疗3 - 6个月。比较治疗前后关节弹响、开口型及关节疼痛的变化。通过MRI比较治疗前后盘位置、盘 - 髁突角及髁突骨质的变化。对治疗前后的盘 - 髁突角进行配对t检验，对盘位置变化进行Fisher确切概率检验，其他计数资料以率（%）表示。ARS治疗后，关节弹响、异常开口、关节疼痛及盘移位的有效率分别为97%（35/36）、14/18、7/9及95%（36/38）。MRI分析发现治疗前后盘位置差异有统计学意义（<0.001），MRI分析显示治疗前最常见的是前盘移位（48%，25/52）和前外侧盘移位（17%，9/52）。相比之下，治疗后最常见的是正常上盘（75%，39/52）和前盘移位（17%，9/52），治疗后盘内移位未见明显变化。ARS治疗前盘 - 髁突角为（36.09±19.02）°，治疗后为（3.94±10.12）°（t = 9.23，P <0.001）。治疗后，46%（12/16）的患者出现新骨形成，髁突高度恢复。ARS治疗颞下颌关节前盘移位和前外侧移位的临床疗效显著，可恢复大多数有适应证患者的盘 - 髁突关系。
