颞下颌关节椎间盘缩小和固定术

IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2024-09-01 DOI:10.1016/j.jormas.2024.101956
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引用次数: 0

摘要

目的评价开放缝合与微型螺钉固定椎间盘减容固定术治疗颞下颌关节前方椎间盘移位不缩小的临床疗效及稳定性:选取2021年8月-2023年1月在我院接受治疗的颞下颌关节前椎间盘移位不缩小(ADDwR)患者共38例(51侧),其中A组19例(23侧)采用开放式颞下颌关节椎间盘缩小固定术治疗,B组19例(28侧)采用颞下颌关节椎间盘缩小缝合术治疗。比较两组患者术前和术后的磁共振成像(MRI)数据,评估关节盘缩小的有效率、关节盘长度的变化、最大椎间隙(MIO)以及术前和术后的数字评分量表(NRS):A组椎间盘减薄术后6个月的MRI有效率为95.65%(22/23),椎间盘长度增加1.74mm,最大椎间孔开度(MIO)为40.32±5.067mm,NRS为0.47±0.697。B 组患者椎间盘缩小术后 6 个月的 MRI 有效率为 100%(28/28)。椎间盘长度增加 1.78mm,MIO 为 41.58±3.746mm,NRS 为 0.00。两组间无明显差异(P>0.05):颞下颌关节盘减张缝合术和颞下颌关节盘开放固定术可有效减张颞下颌关节盘。结论:颞下颌关节盘减张缝合术和颞下颌关节盘开放固定术可有效缩小颞下颌关节盘,术后6个月颞下颌关节盘稳定性高,疼痛和张口情况均可改善,值得在临床上进一步推广。
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Evaluation of clinical impact of two types of Temporomandibular joint disc reduction and fixation

Objective

To evaluate the clinical effectiveness and stability of open suture versus micro-screw anchored disc reduction and fixation in treating disc displacement without reduction in the anterior temporomandibular joint.

Methods

A total of 38 patients (51 sides) with anterior disc displacement without reduction (ADDwR) of the TMJ treated in our hospital from August 2021 to January 2023 were selected, including 19 cases in group A (23 sides) treated with open temporomandibular joint disc reduction and anchorage, and 19 cases in group B (28 sides) treated with temporomandibular joint disc reduction and suture. The Magnetic Resonance Imaging (MRI) data of the two groups before and after operation were compared to evaluate the effective rate of articular disc reduction, the change of articular disc length, The Maximal Interincisal Opening (MIO) and Numeric Rating Scale (NRS) were measured before and after operation.

Results

In group A, the MRI effective rate 6 months after disc reduction was 95.65 % (22/23), the disc length gain was 1.74 mm, MIO was 40.32±5.067 mm, and NRS was 0.47±0.697. The MRI effective rate 6 months after disc reduction in group B was 100 % (28/28). The disc length gain was 1.78 mm, MIO was 41.58±3.746 mm, and NRS was 0.00. There was no significant difference between the two groups (P > 0.05).

Conclusions

TMJ disc reduction and suture and open TMJ disc anchorage can effectively reduce the TMJ disc. The TMJ disc stability is high at 6 months after operation, and the pain and mouth opening can be improved, which is worthy of further promotion in clinical practice.

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来源期刊
Journal of Stomatology Oral and Maxillofacial Surgery
Journal of Stomatology Oral and Maxillofacial Surgery Surgery, Dentistry, Oral Surgery and Medicine, Otorhinolaryngology and Facial Plastic Surgery
CiteScore
2.30
自引率
9.10%
发文量
0
审稿时长
23 days
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