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单独关节内注射类固醇或单独关节穿刺治疗颞下颌关节内紊乱的疗效比较。

A comparison of the outcomes following intra-articular steroid injection alone or arthrocentesis alone in the management of internal derangement of the temporomandibular joint.

作者信息

Singh Surya Udai, Prasad Rajendra B, Punga Rohit, Datta Rahul, Singh Neeraj

机构信息

Department of Oral and Maxillofacial Surgery, AB Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, Karnataka, India.

Department of Oral and Maxillofacial Surgery, Sharda University, Noida, Uttar Pradesh, India.

出版信息

Natl J Maxillofac Surg. 2022 Aug;13(Suppl 1):S80-S84. doi: 10.4103/njms.njms_291_21. Epub 2022 Aug 20.

Abstract

CONTEXT

One of the main causes of chronic facial pain is temporomandibular disorders (TMDs) which may turn out to be a major cause for disability. The two types of treatment strategies may be undertaken to counter temporomandibular joint (TMJ) disorders, namely conservative management and surgical intervention. Surgical management can be classified into invasive open methods and minimally invasive procedures such as arthrocentesis, intra-articular steroid injection, and arthroscopy.

AIMS

The aim of this study is to compare the efficacy of Kenacort (Triamcinolone) as an intra-articular corticosteroid injection and arthrocentesis for lysis and lavage, for the treatment of the temporomandibular joint disorders.

SUBJECTS AND METHODS

Twenty patients with internal derangement of temporomandibular joint (IDTMJ) not responding to conservative management and meeting the inclusion criteria randomly underwent either intra-articular steroid injection or arthrocentesis and the results of the two procedures were evaluated and compared.

STATISTICAL ANALYSIS USED

Unpaired -test, repeated-measures ANOVA. A value of < 0.05 is considered to be statistically significant.

RESULTS AND CONCLUSION

Both procedures turned out to be successful in reducing pain and improving mouth opening, both in a short-term and a long-term use. Upon comparison in our series of patients, arthrocentesis was noted to be a better treatment modality in the long term for the management of IDTMJ.

摘要

背景

慢性面部疼痛的主要原因之一是颞下颌关节紊乱症(TMDs),它可能成为致残的主要原因。针对颞下颌关节(TMJ)紊乱症可采取两种治疗策略,即保守治疗和手术干预。手术治疗可分为侵入性开放手术和微创手术,如关节穿刺术、关节内类固醇注射和关节镜检查。

目的

本研究的目的是比较关节内注射皮质类固醇药物康宁克通(曲安奈德)和用于溶解与灌洗的关节穿刺术治疗颞下颌关节紊乱症的疗效。

对象与方法

20例颞下颌关节内紊乱(IDTMJ)患者,经保守治疗无效且符合纳入标准,随机接受关节内类固醇注射或关节穿刺术,对两种治疗方法的结果进行评估和比较。

所用统计分析方法

非配对t检验、重复测量方差分析。P值<0.05被认为具有统计学意义。

结果与结论

两种治疗方法在短期和长期使用中均能成功减轻疼痛并改善张口度。在我们的系列患者中进行比较时,发现关节穿刺术从长期来看是治疗IDTMJ的更好治疗方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/327d/9651214/1323c0ded94a/NJMS-13-80-g001.jpg

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