Tang Y H, van Bakelen N B, Spijkervet F K L
Ned Tijdschr Tandheelkd. 2024 May;131(5):223-230. doi: 10.5177/ntvt.2024.05.23088.
The initial treatment of symptomatic disorders of the temporomandibular joint typically consists of a conservative approach, in which medication (painkillers and muscle relaxants), orofacial physiotherapy and splints are most important. In most cases, minimally invasive treatment options, such as arthrocentesis, arthroscopy or joint injections, are only considered when conservative methods provide insufficient symptom reduction. There is, however, an ongoing debate about the optimal treatment strategy due to an increasing body of evidence concerning the superior effectiveness in symptom reduction of minimally invasive treatment options with regard to conservative treatments. If these minimally invasive treatment options are also ineffective, open joint surgery may be considered as a last option for a select group of patients.
颞下颌关节症状性疾病的初始治疗通常采用保守方法,其中药物治疗(止痛药和肌肉松弛剂)、口腔颌面物理治疗和咬合板最为重要。在大多数情况下,只有当保守方法无法充分减轻症状时,才会考虑采用微创治疗方法,如关节穿刺术、关节镜检查或关节注射。然而,由于越来越多的证据表明微创治疗方法在减轻症状方面比保守治疗更有效,因此关于最佳治疗策略的争论仍在继续。如果这些微创治疗方法也无效,对于一小部分患者,可以考虑将开放性关节手术作为最后的选择。