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稳定夹板与低强度激光治疗对慢性不可复性移位颞下颌关节盘闭口绞锁患者的疗效:一项平行随机临床试验。

Efficacy of stabilisation splint and low-level laser therapy for patients with chronic closed lock from non-reducible displaced temporo-mandibular joint discs: A parallel randomised clinical trial.

作者信息

El-Shaheed Noha H, Mostafa Aisha Z H, Aboelez Marwa A

机构信息

Faculty of Dentistry, Mansoura University, Mansoura, Egypt.

出版信息

J Oral Rehabil. 2023 Mar;50(3):177-193. doi: 10.1111/joor.13405. Epub 2023 Jan 5.

Abstract

BACKGROUND

Stabilisation splint therapy (SST) and low-level laser therapy (LLLT) are effective-invasive treatment for temporo-mandibular disorder (TMD) patients. However, the specific efficacy of each therapy in patients with chronic closed lock (CCL) from temporo-mandibular joints (TMJ) disc displacement without reduction (DDwoR) remains unknown.

OBJECTIVES

The aim of this study was to assess and compare the efficacy of SST and LLLT alone or in combination in patients with CCL from TMJ DDwoR.

METHODS

This parallel randomised clinical trial included 42 patients who were diagnosed with CCL from TMJ DDwoR. Patients were allocated equally and randomly into three treatment groups: group I received combined SST and LLLT, group II received LLLT and group III received SST. Maximum mouth opening (MMO), visual analogue scale (VAS), muscle and joint palpation scores and time required to achieve normal state were evaluated at baseline, 1, 2, 4 weeks, 3 and 6 months after the intervention. Data were collected and analysed using SPSS software.

RESULTS

Regarding MMO and VAS, a statistically significant improvement was found between group I versus group II and versus group III at all evaluation times. Regarding muscle and joint palpation scores, a statistically significant difference was found between group I versus group III, while non-significant difference was found between group I and group II. A statistically significant faster improvement was found in group I versus group III and versus group II.

CONCLUSION

All treatment modalities can be effective in management of CCL from a TMJ DDwoR cases, but the combined SST and LLLT group seems to provide the best and quickest improvement.

CLINICAL TRIAL REGISTRATION NUMBER

NCT05548894.

摘要

背景

稳定型咬合板治疗(SST)和低强度激光治疗(LLLT)是治疗颞下颌关节紊乱病(TMD)患者的有效侵入性治疗方法。然而,每种治疗方法对颞下颌关节(TMJ)盘移位不可复性(DDwoR)导致的慢性闭锁(CCL)患者的具体疗效尚不清楚。

目的

本研究旨在评估和比较SST和LLLT单独或联合应用于TMJ DDwoR导致的CCL患者的疗效。

方法

这项平行随机临床试验纳入了42例被诊断为TMJ DDwoR导致CCL的患者。患者被平等随机地分为三个治疗组:第一组接受SST和LLLT联合治疗,第二组接受LLLT治疗,第三组接受SST治疗。在干预前、干预后1周、2周、4周、3个月和6个月评估最大开口度(MMO)、视觉模拟评分(VAS)、肌肉和关节触诊评分以及达到正常状态所需的时间。使用SPSS软件收集和分析数据。

结果

关于MMO和VAS,在所有评估时间点,第一组与第二组以及与第三组之间均发现有统计学意义的改善。关于肌肉和关节触诊评分,第一组与第三组之间存在统计学意义的差异,而第一组与第二组之间无显著差异。第一组与第三组以及与第二组相比,改善速度更快,具有统计学意义。

结论

所有治疗方式对TMJ DDwoR导致的CCL病例的治疗可能都是有效的,但SST和LLLT联合治疗组似乎能提供最佳和最快的改善效果。

临床试验注册号

NCT05548894。

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