应用MRI评估口腔黏膜下纤维化患者术前和术后颞下颌关节变化:一项前瞻性研究

Dimple Sehia, Shiva Kumar H R, K. Rai, Raj Keerthi
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引用次数: 0

摘要

评估口腔黏膜下纤维化患者因固定和再活动导致的颞下颌关节改变。研究人群分为两组,分别为患者和正常人11例,共22个颞下颌关节。所有患者术前、术后5个月及对照组均行MRI检查。在所有MRI扫描中评估椎间盘厚度(前、中、后区)、椎间盘长度、关节间隙以及关节窝和髁突头的结构变化。注意到变化的严重程度与张嘴减少的持续时间有关。最后观察脱臼后第5个月颞下颌关节的再生潜力。所有的测量结果都被制成表格并进行统计分析。研究表明术前和正常情况有显著差异。治疗后的数值/维度与正常人群比较相同(除了右侧关节间隙和左侧椎间盘长度可以忽略不计)。这证明在5个月的时间里,治疗使情况与正常尺寸相当,看到了TMJ再生和修复的潜在能力。该研究显示,与对照组相比,具有不同程度张嘴受限的OSMF患者的颞下颌关节成分发生了统计学上高度显著的变化,并且在POD 5个月时关节结构恢复,需要早期干预。
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Evaluation of temporomandibular joint changes seen in pre-operative and post-operative patients of oral submucous fibrosis using MRI: A prospective study
To evaluate alterations in temporomandibular joint due to immobilisation and re-mobilisation in oral submucous fibrosis patients. The study population included 2 groups, patients and normal – 22 TMJ’s of 11 individuals respectively. MRI was performed on all patients pre-operatively and 5 month post-operatively and also on controls. Disc thickness (anterior, intermediate and posterior zone), disc length, joint space and structural changes in the glenoid fossa and condylar head were assessed in all the MRI scans. The severity of changes in relation to duration of reduced mouth opening was noted. And, finally regeneration potential of the TMJ after remobilizing the jaw, on 5th month POD was observed. All the measurements were tabulated and subjected to statistical analysis. The study showed that there were significant differences in the pre-op and normal. The post treatment values/dimensions were comparatively the same as that of the normal population (except for joint space on right side and disc length on left side, which is negligible). It proves that the treatment makes the condition comparably similar to that of normal dimension over a time period of 5 months, sighting the potential capacity of the TMJ to regenerate and repair. The study revealed statistically highly significant changes in the components of Temporomandibular joint in OSMF patients with varying degrees of restriction in mouth opening when compared to controls, and return of the joint structurally towards recovery at 5 month POD stresses upon the need for an early intervention.
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