Losev F F, Nadtochiy A G, Starikov N A, Babunashvili G B, Rudakov A M, Vataeva A A
Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia.
First Moscow State Medical University named after I.V. Sechenov, Moscow, Russia.
Stomatologiia (Mosk). 2024;103(6):30-34. doi: 10.17116/stomat202410306130.
Was to assess an impact of positioning occlusal splints made by various methods on the position of the articular disc of the temporomandibular joint according to MRI data.
40 patients (8 men and 32 women) aged from 18 to 60 years with temporomandibular joint pain dysfunction syndrome were examined (ICD-10 code K07.60). Patients were treated with splint therapy using traditional splints made with combined method (20 patients) and subtractive occlusal splints made by CAD/CAM technology (20 patients). All patients had MRI of the temporomandibular joints before splint therapy and at the final stage of treatment to determine the position of the articular disc in the habitual occlusion and at maximum mouth opening.
After splint therapy, patients in both groups showed an improvement in the position of the articular disc in the usual occlusion: the rate of patients with bilateral dislocation of the articular disc decreased from 85% to 67.5%, and with unilateral articular disc dislocation decreased from 15% to 10%. With maximum mouth opening, complete reposition of the articular disc in both joints were recorded in 22.5%; the rate of patients with bilateral disorder of articular disc repositioning decreased from 85% to 67.5%, and with unilateral disorder of articular disc repositioning decreased from 15% to 10%.
Splint therapy had a pronounced positive clinical effect in patients with pain dysfunction syndrome in the temporomandibular joints. Splint therapy is more effective in correcting sagittal dislocation of the articular disc than transversal dislocation. The study showed comparable treatment results when using traditional and digital occlusal splints.
根据MRI数据评估采用不同方法制作的咬合板定位对颞下颌关节关节盘位置的影响。
对40例年龄在18至60岁之间患有颞下颌关节疼痛功能障碍综合征的患者（ICD - 10编码K07.60）进行检查。患者接受夹板治疗，其中20例使用联合方法制作的传统夹板，20例使用CAD/CAM技术制作的减法咬合板。所有患者在夹板治疗前和治疗最后阶段均进行颞下颌关节MRI检查，以确定关节盘在习惯性咬合和最大开口时的位置。
夹板治疗后，两组患者在正常咬合时关节盘位置均有改善：关节盘双侧脱位患者比例从85%降至67.5%，单侧关节盘脱位患者比例从15%降至10%。在最大开口时，两个关节的关节盘完全复位的患者占22.5%；关节盘复位双侧紊乱患者比例从85%降至67.5%，单侧关节盘复位紊乱患者比例从15%降至10%。
夹板治疗对颞下颌关节疼痛功能障碍综合征患者有显著的积极临床效果。夹板治疗在纠正关节盘矢状位脱位方面比横向脱位更有效。研究表明，使用传统咬合板和数字化咬合板的治疗效果相当。
