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青少年不可复性关节盘前移位伴急性关节盘移位的物理治疗和非手术手法复位联合前定位夹板治疗。

Physical therapy and non-surgical manual disc reduction combined with anterior repositioning splint for acute disc displacement without reduction of the temporomandibular joint in adolescents.

机构信息

Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 500 Quxi Road, Shanghai, 200011, China.

Department of Rehabilitation Medicine, The Third Xiangya Hospital, Central South University, Hunan, China.

出版信息

Clin Oral Investig. 2024 Sep 7;28(10):517. doi: 10.1007/s00784-024-05910-0.

Abstract

OBJECTIVES

Current studies on the treatment of adolescent patients with disc displacement without reduction (DDWOR) are limited by short follow-up periods and small sample sizes, and there are few comparative studies on the efficacy of conservative treatment with and without disc reduction for acute DDWOR. This study compared the therapeutic effects of two conservative treatment methods: physical therapy alone and physical therapy combined with non-surgical manual disc reduction and anterior repositioning splints (ARS), in adolescent patients with acute DDWOR.

MATERIALS AND METHODS

This retrospective study included adolescent patients with DDWOR who underwent physical therapy at the Temporomandibular Joint Rehabilitation Department of the Shanghai Ninth People's Hospital from January 2018 to December 2021. Patient assessment data were collected before and after treatment. Patients were followed up through telephone and online questionnaires from March to August 2023.

RESULTS

The results indicate that compared to physical therapy alone, the combination of physical therapy and non-surgical manual disc reduction with ARS showed better short-term efficacy, improved mouth opening, and better long-term pain control. Also, it may be effective in preventing degenerative joint disease.

CONCLUSIONS

This combination therapy is recommended for clinical application in adolescent patients with acute DDWOR.

CLINICAL RELEVANCE

The present research demonstrates the superior efficacy of physical therapy and non-surgical manual disc reduction combined with anterior repositioning splint in adolescent patients with acute DDWOR.

摘要

目的

目前关于青少年不可复性盘前移位(DDWOR)患者的治疗研究受到随访时间短和样本量小的限制,对于急性 DDWOR 保守治疗加与不加盘复位的疗效比较研究较少。本研究比较了两种保守治疗方法在青少年急性 DDWOR 患者中的疗效:单纯物理治疗与物理治疗联合非手术手动盘复位和前定位夹板(ARS)。

材料和方法

这是一项回顾性研究,纳入了 2018 年 1 月至 2021 年 12 月在上海第九人民医院颞下颌关节康复科接受物理治疗的 DDWOR 青少年患者。在治疗前后收集患者评估数据。通过电话和在线问卷调查,在 2023 年 3 月至 8 月对患者进行随访。

结果

结果表明,与单纯物理治疗相比,物理治疗联合非手术手动盘复位加 ARS 治疗在短期疗效、张口度改善和长期疼痛控制方面表现更好,而且可能有效预防退行性关节病。

结论

本联合治疗推荐用于青少年急性 DDWOR 患者的临床应用。

临床意义

本研究表明,对于青少年急性 DDWOR 患者,物理治疗联合非手术手动盘复位加前定位夹板治疗效果更好。

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