Fan Xingda, Hua Jiangshan, Lu Chuan, Nie Xin, Zheng Yuanli, He Dongmei
School of Stomatology of Qingdao University, Qingdao, Shandong, 266003, China; Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
J Craniomaxillofac Surg. 2023 May 15. doi: 10.1016/j.jcms.2023.04.009.
To compare the short-term clinical results between disc repositioning by open surgery (DROS) and stabilization splint (SS) for the treatment of temporomandibular joint (TMJ) anterior disc displacement without reduction (ADDwoR). Patients diagnosed with ADDwoR by magnetic resonance imaging (MRI) and treated by either DROS or SS from June 2020 to January 2022 were reviewed. They were selected to match the baseline data before each treatment and then to compare the clinical results including maximum interincisal opening (MIO), protrusion and lateral excursion distances, visual analogue scale (VAS) scores of pain, diet, and quality of life (QoL) and their effective rates, total satisfaction rate after 3 and 6 months of the treatment, and between the 2 treatment methods. SPSS software was used to analyze the statistical differences. A total of 175 patients were included in the study. There were 95 patients in the DROS group and 80 patients in the SS group. MIO and VAS scores were significantly improved after each treatment at 3 and 6 months (p < 0.05). DROS improved more at 6 months than 3 months (p < 0.001), whereas SS had no significant changes (p > 0.05). DROS had significantly better MIO, VAS score and effect rates than SS (p < 0.001). The total satisfaction rate was 94.73% in DROS and 86.25% in SS. The protrusion and lateral excursions decreased after DROS at 3 months (p < 0.001) but improved at 6 months to better than before the surgery (p = 0.03, p = 0.10). There were no significant changes in protrusion and lateral excursions after SS (p > 0.05, p > 0.05). DROS had better short-term clinical results than SS in the treatment of ADDwoR.
比较开放性手术椎间盘复位(DROS)与稳定夹板(SS)治疗颞下颌关节(TMJ)不可复性盘前移位(ADDwoR)的短期临床效果。回顾2020年6月至2022年1月期间经磁共振成像(MRI)诊断为ADDwoR并接受DROS或SS治疗的患者。选取他们以匹配每次治疗前的基线数据,然后比较临床结果,包括最大切牙间开口度(MIO)、前伸和侧方运动距离、疼痛视觉模拟量表(VAS)评分、饮食及生活质量(QoL)及其有效率、治疗3个月和6个月后的总满意度以及两种治疗方法之间的差异。使用SPSS软件分析统计学差异。本研究共纳入175例患者。DROS组95例,SS组80例。每次治疗后3个月和6个月时,MIO和VAS评分均显著改善(p<0.05)。DROS在6个月时比3个月时改善更明显(p<0.001),而SS无显著变化(p>0.05)。DROS的MIO、VAS评分及有效率均显著优于SS(p<0.001)。DROS的总满意度为94.73%,SS为86.25%。DROS治疗后3个月时前伸和侧方运动距离减小(p<0.001),但6个月时改善,优于手术前(p=0.03,p=0.10)。SS治疗后前伸和侧方运动距离无显著变化(p>0.05,p>0.05)。在治疗ADDwoR方面,DROS的短期临床效果优于SS。