David Faustino Ângelo, Helcio Yogi Ono, Romualdo Cardoso Monteiro de Barros, Francesco Maffia, David Sanz, Henrique José Cardoso
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引用次数: 0
摘要
目的：本研究旨在评估双侧颞下颌关节镜手术对不同威尔克斯分期患者的疗效，在更大范围内比较不同关节镜级别的手术效果，统一类似人群：在葡萄牙和巴西进行颞下颌关节手术的三个颞下颌关节科室开展了一项多中心前瞻性临床研究，入选窗口期为2019年1月1日至2022年12月1日。主要临床结果是通过视觉模拟量表评估颞下颌关节疼痛。次要临床结果是最大张口度（MMO）。颞下颌关节镜手术采用 1.9 毫米关节镜，包括一个带有 2.8 毫米外保护套管的视频系统。平均年龄为 35.3 岁。所有威尔克斯分期的术后 VAS 疼痛均明显减轻。与威尔克斯 III 期和 IV 期相比，威尔克斯 II 期的 VAS 疼痛值最低。在次要结果中，观察到 MMO 在所有 Wilkes 分期中都有明显改善：在这项多中心研究中，双侧颞下颌关节镜手术被证明是一种有效的治疗方法，可减轻不同威尔克斯分期患者的疼痛并增加其最大张口度，是一种有效的微创解决方案。
Outcomes of bilateral temporomandibular joint arthroscopy: an international multicentric prospective study including 524 joints.
Purpose: This study aimed to evaluate the efficacy of bilateral TMJ arthroscopy in patients with different Wilkes stages, comparing the results obtained in different arthroscopic levels on a larger scale, unifying similar populations.
Methods: A multicentric prospective clinical study was conducted in three TMJ departments performing temporomandibular joint surgery in Portugal and Brazil, with an enrolling window active from January 1, 2019, to December 1, 2022. The primary clinical outcome was TMJ pain evaluated through a visual analogue scale. The secondary clinical outcome was the maximum mouth opening (MMO). TMJ arthroscopy was performed with a 1.9-mm arthroscope, including a video system with a 2.8-mm outer protective cannula.
Results: 262 patients, representing a total of 524 operated joints were enrolled. The mean age was 35.3 years. A significant decrease postoperatively in VAS pain was observed for all Wilkes stages. The lowest value of VAS pain was observed in Wilkes II compared to Wilkes III and IV. In the secondary outcome, MMO was observed to have a significant improvement in all Wilkes stages.
Conclusion: In this multicentric study, bilateral TMJ arthroscopy was shown to be an effective procedure to reduce pain and increase maximum mouth opening in patients with different Wilkes stages, representing a valid minimally invasive solution.
期刊介绍：
Oral & Maxillofacial Surgery founded as Mund-, Kiefer- und Gesichtschirurgie is a peer-reviewed online journal. It is designed for clinicians as well as researchers.The quarterly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery and interdisciplinary aspects of cranial, facial and oral diseases and their management. The journal publishes papers of the highest scientific merit and widest possible scope on work in oral and maxillofacial surgery as well as supporting specialties. Practice-oriented articles help improve the methods used in oral and maxillofacial surgery.Every aspect of oral and maxillofacial surgery is fully covered through a range of invited review articles, clinical and research articles, technical notes, abstracts, and case reports. Specific topics are: aesthetic facial surgery, clinical pathology, computer-assisted surgery, congenital and craniofacial deformities, dentoalveolar surgery, head and neck oncology, implant dentistry, oral medicine, orthognathic surgery, reconstructive surgery, skull base surgery, TMJ and trauma.Time-limited reviewing and electronic processing allow to publish articles as fast as possible. Accepted articles are rapidly accessible online.Clinical studies submitted for publication have to include a declaration that they have been approved by an ethical committee according to the World Medical Association Declaration of Helsinki 1964 (last amendment during the 52nd World Medical Association General Assembly, Edinburgh, Scotland, October 2000). Experimental animal studies have to be carried out according to the principles of laboratory animal care (NIH publication No 86-23, revised 1985).
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