Song Zhi-Qiang, Li Chen-Xi, Gong Zhong-Cheng
Department of Oral and Maxillofacial Oncology and Surgery, School/Hospital of Stomatology, The First Affiliated Hospital of Xinjiang Medical University, No. 37 Liyushan South Road, Urumqi, 830054, China.
Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi, 830054, China.
Odontology. 2025 May 10. doi: 10.1007/s10266-025-01121-5.
This study aimed to investigate the prognosis of adolescent patients with anterior disk displacement without reduction (ADDwoR) who were treated with disk repositioning through suturing or arthrocentesis plus hyaluronic acid (HA) combined with stabilization splint (SS). A total of 96 ADDwoR patients aged ranging from 12 to 18 years, were divided into two groups, including 52 patients in Group A (underwent disk repositioning by suturing) and 44 patients in Group B (underwent arthrocentesis plus HA combined with SS). Condylar height, disk length, maximum mouth opening (MMO), maximal protrusive movement (PM), left/right maximal lateral movement (LLM/RLM) and visual analogue scale (VAS) pain scores were comparatively analyzed between the two groups before and after treatment. Baselined data analysis showed there was no statistical significance in condylar height, disk length, MMO, PM, LLM, RLM, and VAS values between two groups preoperatively. Postoperatively, values of condylar height and disk length in Group A were larger than those in Group B (all P < 0.001); whereas PM, LLM, and RLM values of Group B were all significantly larger than those of Group A (all P < 0.001). However, no statistical difference was obtained in MMO and VAS score between two groups after treatment (all P > 0.05). Both two surgical techniques can effectively relieve pain and improve MMO of adolescent patients with ADDwoR. The maximal protrusive and lateral movement of Group B were superior to those of Group A, while the latter can effectively enhance condylar development and prevent mandibular deformities.
本研究旨在探讨采用缝合或关节穿刺加透明质酸（HA）联合稳定夹板（SS）进行盘复位治疗的不可复性盘前移位（ADDwoR）青少年患者的预后。共有96例年龄在12至18岁之间的ADDwoR患者被分为两组，其中A组52例（通过缝合进行盘复位），B组44例（接受关节穿刺加HA联合SS治疗）。对两组治疗前后的髁突高度、盘长度、最大开口度（MMO）、最大前伸运动（PM）、左/右最大侧方运动（LLM/RLM）和视觉模拟评分（VAS）疼痛评分进行了比较分析。基线数据分析显示，两组术前髁突高度、盘长度、MMO、PM、LLM、RLM和VAS值无统计学意义。术后，A组的髁突高度和盘长度值大于B组（均P < 0.001）；而B组的PM、LLM和RLM值均显著大于A组（均P < 0.001）。然而，治疗后两组的MMO和VAS评分无统计学差异（均P > 0.05）。两种手术技术均可有效缓解ADDwoR青少年患者的疼痛并改善MMO。B组的最大前伸和侧方运动优于A组，而后者可有效促进髁突发育并预防下颌骨畸形。
