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颞下颌关节闭锁的保守治疗:一项随机对照试验

Conservative Therapies for TMJ Closed Lock: A Randomized Controlled Trial.

作者信息

Di Giacomo Paola, Di Paolo Carlo, Qorri Erda, Gatto Roberto, Manes Gravina Giovanni, Falisi Giovanni

机构信息

Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy.

Department of Dentistry, Faculty of Medical Sciences, Albanian University, 1001 Tirana, Albania.

出版信息

J Clin Med. 2022 Nov 28;11(23):7037. doi: 10.3390/jcm11237037.

Abstract

Background. Acute anterior disc displacement without reduction (ADDWoR) is characterized by permanent TMJ disc displacement, pain and functional limitations. Occlusal appliances (OA) are among the therapies of choice. Methods. A single-blind randomized study was carried out to compare the therapeutic success of two different types of splints in patients with ADDWoR. A total of 30 subjects were eligible for the study out of the 330 screened. Group I (n = 15) received RA.DI.CA splint therapy and Group II (n = 15) received stabilization splint therapy. Temporomandibular pain, headache, neck pain and functional excursions were evaluated at baseline (T0), after 4 weeks (T1) and after 6 months (T2). Descriptive and inferential statistics were performed. Results. There was a significant increase in maximum jaw opening and a reduction in pain in both groups (p < 0.05), except for neck pain in Group II. Significant differences in between- and within-subject factors emerged in all of the parameters evaluated, especially between T1 and T2 scores, with a greater trend of improvement in Group I than Group II. Conclusion. RA.DI.CA splints were found to be more effective for the considered sample, especially in the treatment of comorbidities and functional movements, probably due to the greater orthopedic action and joint mobilization.

摘要

背景。急性不可复性盘前移位(ADDWoR)的特征为颞下颌关节盘永久性移位、疼痛和功能受限。咬合矫治器(OA)是首选治疗方法之一。方法。开展一项单盲随机研究,比较两种不同类型的矫治器对ADDWoR患者的治疗效果。在330名筛查对象中,共有30名符合研究条件。第一组(n = 15)接受RA.DI.CA矫治器治疗,第二组(n = 15)接受稳定型矫治器治疗。在基线时(T0)、4周后(T1)和6个月后(T2)评估颞下颌疼痛、头痛、颈部疼痛和功能运动范围。进行描述性和推断性统计分析。结果。两组患者的最大开口度均显著增加,疼痛均减轻(p < 0.05),第二组的颈部疼痛除外。在所有评估参数中,组间和组内因素均出现显著差异,尤其是T1和T2评分之间,第一组的改善趋势大于第二组。结论。对于本研究样本,发现RA.DI.CA矫治器更有效,尤其是在治疗合并症和功能运动方面,这可能是由于其更大的矫形作用和关节活动度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea7f/9737370/893790d28e40/jcm-11-07037-g001.jpg

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