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自体脂肪在颞下颌关节强直间置关节成形术治疗中的有效性:一项系统文献综述

The Effectiveness of Using Autologous Fat in Temporomandibular Joint Ankylosis Treatment with Interposition Arthroplasty Method: A Systematic Literature Review.

作者信息

Kilinskaite Gerda, Kilinskaite Nida, Leketas Marijus

机构信息

Department of Maxillofacial Surgery, Lithuania University of Health Sciences, LT-47181 Kaunas, Lithuania.

Faculty of Odontology, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania.

出版信息

Healthcare (Basel). 2025 Sep 8;13(17):2241. doi: 10.3390/healthcare13172241.

Abstract

: Ankylosis of the temporomandibular joint (TMJ) affects physical, psychological, and social well-being and quality of life. One of the most frequently used surgical interventions for the treatment of temporomandibular joint ankylosis is interpositional arthroplasty, particularly in cases where joint preservation is feasible, with different autologous fats: dermis fat, buccal fat pad, and full thickness skin-subcutaneous fat. The aim of the work was to evaluate the efficiency of using different autologous fats in temporomandibular joint ankylosis treatment with interposition arthroplasty method. : This systematic literature review was conducted according to PRISMA guidelines and registered in the PROSPERO database (CRD420251038325). A comprehensive search was performed in PubMed, the Cochrane Library, and ScienceDirect databases using combinations of keywords: (temporomandibular joint disorders OR temporomandibular joint) AND (adipose tissue or autologous) AND (ankylosis OR arthroplasty). Inclusion criteria were clinical studies conducted on human subjects, written in English, that evaluated the use of autologous fat in interpositional arthroplasty for TMJ ankylosis. The main outcome measures included postoperative maximum mouth opening (MMO), pain intensity, and relative fat volume contraction. Risk of bias was assessed using the Cochrane RoB 2 tool for randomized controlled trials and the Newcastle-Ottawa Scale for cohort studies. Most included studies were of moderate to high quality. : A total of 20 publications were selected, including a total of 369 patients. In a qualitative analysis, the best results for maximal opening of mouth (MOM) at 3, 6, 12, and more than 12 months were obtained with dermal fat. After 3 months, the MOM was 40.0 ± 2.7 mm, after 6 months-40.80 ± 4.26 mm, after 12 months-41.9 ± 4.0 mm, after more than 12 months-43.5 mm. The lowest pain intensity was observed using dermal fat taken from the iliac crest region. The rate of volumetric fat shrinkage was greater using buccal fat pad than dermis fat. : The most commonly used types of autologous fat in interposition arthroplasty in ankylosis are the following: dermal fat from the abdominal region (iliac crest, subumbilical area, groin), buccal fat pad and full-thickness subcutaneous fat. The best results after the surgical treatment of TMJ ankylosis with interposition arthroplasty are obtained using dermis fat.

摘要

颞下颌关节强直会影响身体、心理和社会幸福感及生活质量。治疗颞下颌关节强直最常用的外科手术干预之一是间置关节成形术,特别是在可行关节保留的情况下,使用不同的自体脂肪:真皮脂肪、颊脂垫和全层皮肤 - 皮下脂肪。本研究的目的是评估在间置关节成形术治疗颞下颌关节强直中使用不同自体脂肪的效果。 :本系统文献综述按照PRISMA指南进行,并在PROSPERO数据库(CRD420251038325)中注册。在PubMed、Cochrane图书馆和ScienceDirect数据库中进行了全面搜索,使用关键词组合:(颞下颌关节紊乱或颞下颌关节) AND (脂肪组织或自体) AND (强直或关节成形术)。纳入标准是针对人类受试者进行的临床研究,英文撰写,评估自体脂肪在颞下颌关节强直间置关节成形术中的使用。主要结局指标包括术后最大开口度(MMO)、疼痛强度和相对脂肪体积收缩。使用Cochrane RoB 2工具评估随机对照试验的偏倚风险,使用纽卡斯尔 - 渥太华量表评估队列研究的偏倚风险。大多数纳入研究的质量为中等至高。 :共选择了20篇出版物,包括总共369例患者。在定性分析中,真皮脂肪在3个月、6个月、12个月及12个月以上时获得的最大开口度(MOM)最佳结果。3个月后,MOM为40.0±2.7mm,6个月后为40.80±4.26mm,12个月后为41.9±4.0mm,12个月以上后为43.5mm。使用取自髂嵴区域的真皮脂肪时观察到的疼痛强度最低。颊脂垫的脂肪体积收缩率大于真皮脂肪。 :在关节强直间置关节成形术中最常用的自体脂肪类型如下:腹部区域(髂嵴、脐下区域、腹股沟)的真皮脂肪、颊脂垫和全层皮下脂肪。使用真皮脂肪在间置关节成形术治疗颞下颌关节强直后可获得最佳结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c9f/12427945/1e246b5083ed/healthcare-13-02241-g001.jpg

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