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两种颞下颌关节盘复位固定术的临床效果评价

Evaluation of clinical impact of two types of Temporomandibular joint disc reduction and fixation.

机构信息

Guangdong Engineering Research Center of Oral Restoration and Reonstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China.

First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong 510182, China.

出版信息

J Stomatol Oral Maxillofac Surg. 2024 Sep;125(5S1):101956. doi: 10.1016/j.jormas.2024.101956. Epub 2024 Jun 26.

Abstract

OBJECTIVE

To evaluate the clinical effectiveness and stability of open suture versus micro-screw anchored disc reduction and fixation in treating disc displacement without reduction in the anterior temporomandibular joint.

METHODS

A total of 38 patients (51 sides) with anterior disc displacement without reduction (ADDwR) of the TMJ treated in our hospital from August 2021 to January 2023 were selected, including 19 cases in group A (23 sides) treated with open temporomandibular joint disc reduction and anchorage, and 19 cases in group B (28 sides) treated with temporomandibular joint disc reduction and suture. The Magnetic Resonance Imaging (MRI) data of the two groups before and after operation were compared to evaluate the effective rate of articular disc reduction, the change of articular disc length, The Maximal Interincisal Opening (MIO) and Numeric Rating Scale (NRS) were measured before and after operation.

RESULTS

In group A, the MRI effective rate 6 months after disc reduction was 95.65 % (22/23), the disc length gain was 1.74 mm, MIO was 40.32±5.067 mm, and NRS was 0.47±0.697. The MRI effective rate 6 months after disc reduction in group B was 100 % (28/28). The disc length gain was 1.78 mm, MIO was 41.58±3.746 mm, and NRS was 0.00. There was no significant difference between the two groups (P > 0.05).

CONCLUSIONS

TMJ disc reduction and suture and open TMJ disc anchorage can effectively reduce the TMJ disc. The TMJ disc stability is high at 6 months after operation, and the pain and mouth opening can be improved, which is worthy of further promotion in clinical practice.

摘要

目的

评估开放式缝线与微螺钉锚定盘复位固定治疗颞下颌关节前盘不可复性移位的临床疗效和稳定性。

方法

选取 2021 年 8 月至 2023 年 1 月我院收治的颞下颌关节前盘不可复性移位(ADDwR)患者 38 例(51 侧),其中 A 组 19 例(23 侧)采用开放式颞下颌关节盘复位锚定,B 组 19 例(28 侧)采用关节盘复位缝合。比较两组患者术前、术后磁共振成像(MRI)资料,评估关节盘复位有效率、关节盘长度变化、最大开口度(MIO)和数字评分量表(NRS)。

结果

A 组术后 6 个月 MRI 有效率为 95.65%(22/23),盘片长度增加 1.74mm,MIO 为 40.32±5.067mm,NRS 为 0.47±0.697。B 组术后 6 个月 MRI 有效率为 100%(28/28),盘片长度增加 1.78mm,MIO 为 41.58±3.746mm,NRS 为 0.00。两组比较差异无统计学意义(P>0.05)。

结论

TMJ 盘复位缝合和开放式 TMJ 盘锚固均可有效降低 TMJ 盘,术后 6 个月 TMJ 盘稳定性高,疼痛和张口度改善,在临床实践中值得进一步推广。

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