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比较 NSAIDs 与皮质类固醇关节内注射治疗不可复性盘前移位的颞下颌关节紊乱病的疗效

COMPARISON OF EFFICACY OF NSAIDS WITH INTRA- ARTICULAR INJECTION OF CORTICOSTEROIDS IN PATIENTS OF TEMPOROMANDIBULAR DISORDER WITH INTERNAL DISC DISPLACEMENT WITHOUT REDUCTION.

机构信息

Avicenna Medical and Dental College, Lahore-Pakistan, Laiba Dental Clinic Lahore-Pakistan Armed Forces Institute of Dentistry, Rawalpindi-Pakistan Rawal Institute of Health Sciences, Islamabad-Pakistan, Alam Hospital, Lahore-Pakistan.

出版信息

J Ayub Med Coll Abbottabad. 2024 Apr-Jun;36(2):412-416. doi: 10.55519/JAMC-02-13458.

Abstract

BACKGROUND

Temporomandibular disorders (TMD) are a diverse set of musculoskeletal and neuromuscular problems involving the temporomandibular joint complex and surrounding muscles 1. TMD prevalence has varied from one location to the next, with estimates ranging from 6 to 68 % in various types Objectives were to compare the efficacy of NSAIDs with intra-articular injection of corticosteroids in patients suffering from temporomandibular disorders (TMD) due to disc displacement without reduction in terms of mean pain score and mean mouth opening. This Randomized control trial was conducted at the Oral & Maxillofacial Surgery Department, PMC Dental institute, Faisalabad Medical University, Faisalabad, Pakistan, from 6th April 2018 to 6th April 2019.

METHODS

All the diagnosed cases of temporomandibular disorder due to disc displacement without reduction were included. Study group (Group1) was injected with 1ml of Triamcinolone acetonide 40 mg/ml once, every three weeks & Control group (Group 2) was given Naproxen 550 mg two times a day for 3 weeks. Pain and mouth opening were assessed at initial presentation & then after 3 weeks interval.

RESULTS

Total 80 patients were enrolled in the study (40 in each group). The mean age of patients in Control group was 28.73±4.88 years and in study group was 28.68±4.89 years. From 80 patients, 51 (63.80%) were females and 29 (36.20%) were males with 3:1 female to male ratio. Mean pain score was 4.18±0.93 in group 1 and 2.65±0.74 in group 2 after 3 weeks with p-value of 0.0011. Mean mouth opening after 3 weeks was seen as 34.93±1.82 mm in group 1 and 32.28±1.75 mm in group 2 with p-value of 0.0015.

CONCLUSIONS

Intra-articular injections of corticosteroids are better than NSAIDs in reducing pain and improving mouth opening in patients suffering from TMD due to DDwoR.

摘要

背景

颞下颌关节紊乱(TMD)是一组涉及颞下颌关节复合体及其周围肌肉的肌肉骨骼和神经肌肉疾病。TMD 的患病率因地点而异,各种类型的患病率估计在 6%至 68%之间。目的是比较非甾体抗炎药(NSAIDs)与关节内注射皮质类固醇治疗因关节盘不可复位性移位引起的 TMD 患者的疗效,比较两组患者的平均疼痛评分和平均张口度。这是一项随机对照试验,于 2018 年 4 月 6 日至 2019 年 4 月 6 日在巴基斯坦费萨拉巴德医科大学 PMC 牙科研究所口腔颌面外科进行。

方法

所有因关节盘不可复位性移位引起的 TMD 患者均纳入本研究。研究组(第 1 组)接受 1ml 曲安奈德 40mg/ml 注射,每 3 周 1 次,对照组(第 2 组)给予萘普生 550mg,每日 2 次,共 3 周。在初始就诊时和 3 周后评估疼痛和张口度。

结果

共纳入 80 例患者(每组 40 例)。对照组患者的平均年龄为 28.73±4.88 岁,研究组为 28.68±4.89 岁。80 例患者中,女性 51 例(63.80%),男性 29 例(36.20%),男女比例为 3:1。第 1 组治疗 3 周后平均疼痛评分为 4.18±0.93,第 2 组为 2.65±0.74,p 值为 0.0011。第 1 组治疗 3 周后张口度为 34.93±1.82mm,第 2 组为 32.28±1.75mm,p 值为 0.0015。

结论

关节内注射皮质类固醇治疗因关节盘不可复位性移位引起的 TMD 患者,可减轻疼痛,改善张口度,优于 NSAIDs。

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