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一种用于颞下颌关节单针关节穿刺术的定制导向装置。

A customized guide device for single needle arthrocentesis on temporomandibular joint.

作者信息

Jeon Jun-Hyung, Park Sang-Hee, Yun Pil-Young, Ku Jeong-Kui

机构信息

Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.

Department of Oral and Maxillofacial Surgery, School of Dentistry and Institute of Oral Bioscience, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University, Jeonju, Korea.

出版信息

J Korean Assoc Oral Maxillofac Surg. 2025 Apr 30;51(2):95-101. doi: 10.5125/jkaoms.2025.51.2.95.

DOI:10.5125/jkaoms.2025.51.2.95
PMID:40296733
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12041429/
Abstract

OBJECTIVES

: This study aims to evaluate the accuracy and effectiveness of temporomandibular joint (TMJ) arthrocentesis using the three-dimensional (3D)-printed TMJ injection guide in cases of hemarthrosis caused by condyle fractures.

MATERIALS AND METHODS

: A retrospective chart review was conducted for patients treated with the customized TMJ arthrocentesis guide to address hemarthrosis. Inclusion criteria included adults older than 18 years with condylar fractures not indicated for open reduction and internal fixation. The guide was fabricated using computed tomography or cone-beam computed tomography scans and 3D printing to control the degree and depth of the needle through the guide to aspirate hemarthrosis.

RESULTS

: Six joints from five patients (average age 52.4 years) were treated using the guide. Post-procedural magnetic resonance imaging confirmed complete resolution of hemarthrosis in all cases. A representative case demonstrated successful outcomes with normal healing and no complications at 8 months post-procedure.

CONCLUSION

: The customized TMJ injection guide, using ear-based reference points, significantly enhances the accuracy and safety of TMJ arthrocentesis. This innovation is expected to increase the accessibility and effectiveness of TMJ-related treatments for clinicians without specialized TMJ expertise.

摘要

目的

本研究旨在评估在髁突骨折引起关节积血的病例中，使用三维（3D）打印的颞下颌关节注射导向器进行颞下颌关节（TMJ）关节穿刺术的准确性和有效性。

材料与方法

对采用定制的TMJ关节穿刺导向器治疗关节积血的患者进行回顾性病历审查。纳入标准包括年龄大于18岁、髁突骨折不适合切开复位内固定的成年人。该导向器通过计算机断层扫描或锥形束计算机断层扫描以及3D打印制作，以控制通过导向器穿刺抽吸关节积血的针的角度和深度。

结果

使用该导向器治疗了5例患者的6个关节（平均年龄52.4岁）。术后磁共振成像证实所有病例的关节积血均完全消退。一个典型病例显示术后8个月愈合正常且无并发症，取得了成功的结果。

结论

使用基于耳部参考点的定制TMJ注射导向器可显著提高TMJ关节穿刺术的准确性和安全性。这一创新有望提高临床医生在没有专门TMJ专业知识的情况下进行TMJ相关治疗的可及性和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9158/12041429/e4dc7c490ddc/jkaoms-51-2-95-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9158/12041429/ee35c01241de/jkaoms-51-2-95-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9158/12041429/1b7843932d30/jkaoms-51-2-95-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9158/12041429/7dfb84a31427/jkaoms-51-2-95-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9158/12041429/b42e63d92441/jkaoms-51-2-95-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9158/12041429/e4dc7c490ddc/jkaoms-51-2-95-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9158/12041429/ee35c01241de/jkaoms-51-2-95-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9158/12041429/1b7843932d30/jkaoms-51-2-95-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9158/12041429/7dfb84a31427/jkaoms-51-2-95-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9158/12041429/b42e63d92441/jkaoms-51-2-95-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9158/12041429/e4dc7c490ddc/jkaoms-51-2-95-f5.jpg

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本文引用的文献

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A Novel Design of Computer-Assisted 3D-Printed TMJ Arthrocentesis Guide (Technical Note).计算机辅助3D打印颞下颌关节穿刺引导器的新型设计（技术说明）
J Craniofac Surg. 2024 May 13. doi: 10.1097/SCS.0000000000010306.
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Osteoarthritis of the temporomandibular joint: a review of aetiology and pathogenesis.颞下颌关节骨关节炎：病因学和发病机制的综述。
Br J Oral Maxillofac Surg. 2022 May;60(4):387-396. doi: 10.1016/j.bjoms.2021.06.017. Epub 2021 Jul 29.
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Follow-up evaluation of temporomandibular joints using magnetic resonance imaging after mandibular trauma: Case series analysis of young adult males.
下颌骨外伤后采用磁共振成像进行颞下颌关节的随访评估：年轻成年男性的病例系列分析。
Dent Traumatol. 2022 Apr;38(2):136-142. doi: 10.1111/edt.12719. Epub 2021 Nov 22.
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Arthrocentesis of the Temporomandibular Joint: Systematic Review and Clinical Implications of Research Findings.颞下颌关节关节腔穿刺术：研究结果的系统评价及临床意义。
J Oral Facial Pain Headache. 2021;35(1):17-29. doi: 10.11607/ofph.2606.
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Temporomandibular joint arthrocentesis guided by ultrasonography: An anatomical study.超声引导下颞下颌关节关节腔穿刺术：一项解剖学研究。
J Stomatol Oral Maxillofac Surg. 2021 Sep;122(4):e27-e31. doi: 10.1016/j.jormas.2021.03.002. Epub 2021 Mar 8.
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Efficacy of arthrocentesis and lavage for treatment of post-traumatic arthritis in temporomandibular joints.关节穿刺冲洗治疗颞下颌关节创伤后关节炎的疗效
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Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis-Review of the Literature.跨学科方法治疗颞下颌关节骨关节炎——文献综述。
Medicina (Kaunas). 2020 May 9;56(5):225. doi: 10.3390/medicina56050225.
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Computer-Guided Arthrocentesis Using Patient-Specific Guides: A Novel Protocol for Treatment of Internal Derangement of the Temporomandibular Joint.使用患者特异性导板的计算机辅助关节穿刺术：一种治疗颞下颌关节内紊乱的新方案
J Oral Maxillofac Surg. 2020 Mar;78(3):372.e1-372.e7. doi: 10.1016/j.joms.2019.10.005. Epub 2019 Oct 15.
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