Li Hongguang, Han Weihua, Wu Xun, Feng Jiling, Li Gang, Meng Juanhong
Department of Oral and Maxillofacial Surgery, Beijing 100081, China.
Department of Oral and Maxillofacial Radiology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2024 Apr 18;56(2):338-344. doi: 10.19723/j.issn.1671-167X.2024.02.022.
To observe the clinical effect of arthrocentesis combined with liquid phase concentrated growth factor (CGF) injection in the treatment of unilateral temporomandibular joint osteoarthritis (TMJOA), in order to provide a new treatment option for TMJOA patients.
In this non-randomized controlled study, patients diagnosed with unilateral TMJOA who visited the center for temporomandibular joint disorder and orofacial pain of Peking University School and Hospital of Stomatology from June 2021 to January 2023 were selected as research objects. The patients were divided into experimental group and control group, which were selected by patients themselves. The experimental group received arthrocentesis combined with liquid phase CGF injection and the control group received arthrocentesis combined with HA injection. Both groups were treated 3 times, once every two weeks. The clinical effect was evaluated by the maximum mouth opening, pain value and the degree of mandibular function limitation 6 months after treatment. The change of condylar bone was evaluated by cone beam CT (CBCT) image fusion technology before and after treatment.
A total of 20 patients were included in the experimental group, including 3 males and 17 females, with an average age of (34.40±8.41) years. A total of 15 patients were included in the control group, including 1 male and 14 females, with an average age of (32.20±12.00) years. There was no statistical difference in general information between the two groups ( > 0.05). There were no statistical differences in the mouth opening, pain value and the degree of jaw function limitation between the two groups before treatment ( > 0.05), and all of them improved 6 months after treatment compared with before treatment ( < 0.05). However, the mouth opening of experimental group was significantly higher than that of control group 6 months after treatment ( < 0.05), and the degree of jaw function limitation was significantly lower than that of control group ( < 0.05). CBCT 2D images showed that the condylar bone of both groups was smoother after treatment than before treatment, and image fusion results showed that 10 patients (50.0%) in the experimental group and 5 patients (33.3%) in the control group had reparative remodeling area of condylar bone, and there was no statistical difference between them ( > 0.05). Except for one CGF patient, the other patients in both groups had some absorption areas of condylar bone.
The arthrocentesis combined with liquid phase CGF injection can improve the clinical symptoms and signs of unilateral TMJOA patients in short term, and is better than HA in increasing mouth opening and improving jaw function. CBCT fusion images of both patient groups show some cases of condylar bone reparative remodeling and its relevance to treatment plans still requires further study.
观察关节腔穿刺联合液相浓缩生长因子（CGF）注射治疗单侧颞下颌关节骨关节炎（TMJOA）的临床效果，为TMJOA患者提供新的治疗选择。
本非随机对照研究选取2021年6月至2023年1月在北京大学口腔医院颞下颌关节病及口颌面疼痛中心就诊的单侧TMJOA患者作为研究对象。患者自行选择分为试验组和对照组。试验组接受关节腔穿刺联合液相CGF注射，对照组接受关节腔穿刺联合透明质酸（HA）注射。两组均治疗3次，每两周治疗1次。治疗6个月后，通过最大开口度、疼痛值和下颌功能受限程度评估临床效果。采用锥形束CT（CBCT）图像融合技术评估治疗前后髁突骨的变化。
试验组共纳入20例患者，其中男性3例，女性17例，平均年龄（34.40±8.41）岁。对照组共纳入15例患者，其中男性1例，女性14例，平均年龄（32.20±12.00）岁。两组一般资料比较，差异无统计学意义（P>0.05）。治疗前，两组开口度、疼痛值和下颌功能受限程度比较，差异无统计学意义（P>0.05），治疗6个月后均较治疗前有所改善（P<0.05）。然而，治疗6个月后试验组开口度显著高于对照组（P<0.05），下颌功能受限程度显著低于对照组（P<0.）。CBCT二维图像显示，两组治疗后髁突骨均比治疗前更光滑，图像融合结果显示，试验组10例患者（50.0%）和对照组5例患者（33.3%）有髁突骨修复性重塑区域，两者差异无统计学意义（P>0.05）。除1例CGF患者外，两组其他患者均有髁突骨部分吸收区域。
关节腔穿刺联合液相CGF注射可在短期内改善单侧TMJOA患者的临床症状和体征，在增加开口度和改善下颌功能方面优于HA。两组患者的CBCT融合图像均显示部分病例有髁突骨修复性重塑，其与治疗方案的相关性仍需进一步研究。
