Ekberg E C, Sabet M E, Petersson A, Nilner M
Department of Stomatognathic Physiology, Lund University, Malmö, Sweden.
Int J Prosthodont. 1998 May-Jun;11(3):263-8.
The purposes of this study were to compare changes in the condyle-fossa relationship in patients with temporomandibular disorders of arthrogenous origin treated with either a stabilization or a control appliance in a double-blind controlled study, and to compare the changes in the condyle-fossa relationship with the short-term treatment effect in the two treatment groups. The radiographic appearance of the temporomandibular joint was also studied.
Fifty-eight patients with temporomandibular disorders of arthrogenous origin were assigned to two equally sized groups: a treatment group given a stabilization appliance; and a control group, given a control appliance. The study covered 10 weeks. The treatment outcome regarding changes in severity of temporomandibular joint pain on a verbal scale was compared to changes in the condyle-fossa relationship in horizontally corrected oblique lateral transcranial radiographs taken with and without the appliance. Condyle-fossa relationship and structural bone changes were observed before treatment in corrected lateral tomograms.
The group treated with a stabilization appliance showed a changed condylar position significantly more often (P = 0.004) than the control group. Of the patients reporting a successful treatment outcome, significantly more (P = 0.006) showed a changed condyle position in the group treated with a stabilization appliance than in the group treated with a control appliance.
In patients with temporomandibular disorders of arthrogenous origin, the short-term occlusal appliance therapy resulting in a changed condylar position gave relief of symptoms more often than if the condylar position was unchanged.
本研究旨在通过双盲对照研究，比较采用稳定矫治器或对照矫治器治疗的关节源性颞下颌关节紊乱病患者髁突-关节窝关系的变化，并比较两组治疗中髁突-关节窝关系的变化与短期治疗效果。同时还研究了颞下颌关节的影像学表现。
58例关节源性颞下颌关节紊乱病患者被平均分为两组：一组为治疗组，佩戴稳定矫治器；另一组为对照组，佩戴对照矫治器。研究为期10周。将根据视觉模拟评分法得出的颞下颌关节疼痛严重程度变化的治疗结果，与佩戴和不佩戴矫治器时拍摄的水平校正斜侧位经颅X线片中髁突-关节窝关系的变化进行比较。在治疗前的校正侧位断层片上观察髁突-关节窝关系和骨质结构变化。
与对照组相比，佩戴稳定矫治器治疗的组髁突位置改变的情况明显更常见（P = 0.004）。在报告治疗成功的患者中，佩戴稳定矫治器治疗的组中髁突位置改变的患者明显多于佩戴对照矫治器治疗的组（P = 0.006）。
对于关节源性颞下颌关节紊乱病患者，短期咬合矫治器治疗使髁突位置发生改变时，比髁突位置未改变时更常能缓解症状。
