Department of Oral and Maxillofacial Surgery, Uşak University, Faculty of Dentistry, Cumhuriyet Mh. Kolej Sk. No:3, 64200, Uşak, Turkey.
Department of Oral and Maxillofacial Surgery, Sakarya University, Faculty of Dentistry, Sakarya, Turkey.
J Stomatol Oral Maxillofac Surg. 2023 Oct;124(5):101438. doi: 10.1016/j.jormas.2023.101438. Epub 2023 Mar 12.
Disc displacement without reduction (DDWoR) of the temporomandibular joint is associated with limited mouth opening and arthralgia. In the natural course of the disorder, there is a tendency to progress to degenerative joint diseases. First-line treatment aims to reduce pain and restore joint function. The current study aims to examine the efficacy of an occlusal stabilization splint applied simultaneously with arthrocentesis as first-line treatment in acute and chronic closed-locks.
The present prospective clinical trial included 40 patients who were diagnosed with DDWoR induced chronic (Group 1, n = 23) and acute (Group 2, n = 17) closed-locks. All participants underwent single session arthrocentesis and were applied occlusal stabilization splints. Maximum mouth opening amounts (MMO), Visual analogue scale (VAS), and McGill pain questionnaire (MPQ) scores were evaluated at baseline, on the operation day, and on seven days after the intervention. The obtained data was analyzed with the Wilcoxon signed-rank, Mann-Whitney U, Fisher's exact, Spearman's correlation tests.
According to the baseline data, a significant increase was observed in the amount of MMO in postoperative measurements (p = 0.001 and p < 0.001). A statistically significant decrease in MPQ scores was observed in the postoperative period (p < 0.001 and p < 0.001). While a significant difference was observed between the postoperative VAS scores, the scores of Group 2 were lower (p = 0.018).
Although combined arthrocentesis and occlusal stabilization splint provided significant changes for acute and chronic closed-locks in line with first-line treatment goals, acute closed-lock with arthralgia responded better.
NCT05671549.
颞下颌关节不可复性关节盘移位（DDWoR）与张口受限和关节痛有关。在疾病的自然病程中，有向退行性关节病进展的趋势。一线治疗旨在减轻疼痛并恢复关节功能。本研究旨在探讨关节腔穿刺术联合咬合稳定夹板作为急性和慢性闭锁的一线治疗的疗效。
本前瞻性临床试验纳入了 40 名被诊断为 DDWoR 引起的慢性（第 1 组，n=23）和急性（第 2 组，n=17）闭锁的患者。所有患者均接受单次关节腔穿刺术，并应用咬合稳定夹板。在基线、手术当天和干预后 7 天评估最大张口量（MMO）、视觉模拟量表（VAS）和 McGill 疼痛问卷（MPQ）评分。采用 Wilcoxon 符号秩检验、Mann-Whitney U 检验、Fisher 确切检验、Spearman 相关检验对获得的数据进行分析。
根据基线数据，术后测量的 MMO 量显著增加（p=0.001 和 p<0.001）。术后 MPQ 评分明显下降（p<0.001 和 p<0.001）。虽然术后 VAS 评分存在显著差异，但第 2 组的评分较低（p=0.018）。
尽管联合关节腔穿刺术和咬合稳定夹板治疗急性和慢性闭锁符合一线治疗目标，但伴有疼痛的急性闭锁反应更好。
NCT05671549。
