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与颞下颌关节关节镜手术疗效相关的临床和人口统计学因素。

Clinical and demographic factors associated with the effectiveness of temporomandibular joint arthroscopy.

机构信息

Department of Maxillofacial Surgery, Hospital del Trabajador, ACHS, Santiago, Chile.

Private Practice, Oral and Maxillofacial Surgery at Clinica Santa Maria and Clinica Universidad de los Andes, Santiago, Chile.

出版信息

Oral Maxillofac Surg. 2024 Mar;28(1):405-411. doi: 10.1007/s10006-023-01158-2. Epub 2023 May 24.

Abstract

PURPOSE

High success rates and minimal complications have consolidated arthroscopy as the therapeutic alternative of choice for minimally invasive treatment of internal disorders (ID) of the temporomandibular joint (TMJ). However, there is no certainty regarding the demographic and clinical factors associated with the technique's success or failure. This study was performed to analyze the effectiveness of arthroscopy regarding pain and the mandibular dynamics and also to determine whether variables such as age, sex, and preoperative Wilkes stage influence the results.

METHODS

A retrospective study was conducted involving 92 patients with ID of the TMJ between September 2017 and February 2020. In all cases, a first stage of intra-articular lysis and lavage was executed. As needed, a phase of operative arthroscopy or arthroscopic discopexy was implemented.

RESULTS

A total of 152 arthroscopies were performed. Both the variation in pain and mouth opening in patients with ID of the TMJ treated were statistically significant for the follow-up periods studied. Better results were observed for patients with lower Wilkes stages. No association with age was found.

CONCLUSION

Based on the results, we recommend early intervention as soon as an ID in the TMJ is detected.

摘要

目的

高成功率和低并发症使关节镜成为治疗颞下颌关节(TMJ)内部疾病(ID)的微创治疗的首选方法。然而,对于与该技术成功或失败相关的人口统计学和临床因素,尚无定论。本研究旨在分析关节镜治疗 TMJ ID 的有效性,包括疼痛和下颌动力学,并确定年龄、性别和术前 Wilkes 分期等变量是否会影响结果。

方法

对 2017 年 9 月至 2020 年 2 月期间的 92 例 TMJ ID 患者进行了回顾性研究。在所有情况下,均进行了关节内松解和灌洗的第一阶段。如有需要,可进行关节镜或关节镜下盘固定术。

结果

共进行了 152 次关节镜检查。在研究的随访期间,TMJ ID 患者的疼痛和张口变化均具有统计学意义。Wilkes 分期较低的患者结果更好。与年龄无相关性。

结论

根据结果,我们建议一旦发现 TMJ 的 ID 就应尽早干预。

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