TMJ关节镜术后恢复:咀嚼改善和术后饮食

D. Ângelo, André Prior, H. Cardoso
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The data were compared with preoperative results using descriptive statistics, one-way ANOVA, and the Friedman test. The level of significance was set at p < 0.05. Results: Forty-two patients were assessed for eligibility; fifteen did not meet the inclusion criteria, and five declined participation. Twenty-two patients initially started the study, but two canceled on days 6–18, and eleven patients tested positive for SARS-CoV-2. Nine female patients with sixteen operated joints completed the study. A progressive tolerance for scaling food textures was observed. Soft and medium textures were tolerated after D15 and D21, respectively. The hard texture was not well tolerated in the 30 days after surgery. Discomfort returning to work and practicing physical exercise was significantly reduced on D15 and D21, respectively. In addition, significant improvements in TMJ pain during mastication and speech were observed over time. 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引用次数: 1

摘要

背景:颞下颌关节镜检查因其远期疗效满意且手术并发症少而受到广泛应用。然而,对患者术后恢复的研究甚少。本研究评估TMJ关节镜术后患者咀嚼功能和日常活动的变化。方法:在葡萄牙一家口面部疼痛中心对符合TMJ关节镜检查标准的患者进行前瞻性研究。术后前30天(D),每3天对患者进行评分:(1)咀嚼不同质地食物(软、中、硬)的不适感;(2)恢复正常生活方式(工作、体育活动)的时间;(3)基本功能(咀嚼、说话、吞咽、深呼吸)时TMJ疼痛。使用描述性统计、单因素方差分析和Friedman检验将数据与术前结果进行比较。p < 0.05为显著性水平。结果:42例患者入选;15个不符合纳入标准,5个拒绝参与。22名患者最初开始了这项研究,但有2名患者在第6-18天取消了这项研究,11名患者的SARS-CoV-2检测呈阳性。9名女性患者共手术了16个关节,完成了研究。观察到对食物质地结垢的逐渐耐受性。D15和D21分别耐受软质和中等质地。在术后30天内,硬质不能很好地耐受。在第15天和第21天,重返工作岗位和进行体育锻炼的不适感分别显著减少。此外,随着时间的推移,在咀嚼和说话时观察到TMJ疼痛的显著改善。结论:尽管本研究的局限性,即样本量小,问卷未经过验证,食物质地的非生物力学分析,但有可能观察到TMJ关节镜术后随着不同食物质地的逐步引入,咀嚼能力的早期恢复。作者期望这些结果将有助于未来关于TMJ关节镜术后恢复的术后指南。
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Postoperative Recovery after TMJ Arthroscopy: Masticatory Improvement and Postoperative Diet
Background: Temporomandibular joint (TMJ) arthroscopy has become popular due to its satisfactory long-term results and few surgical complications. However, patients’ postoperative recovery is poorly studied. This study evaluates the postoperative evolution of the masticatory function and the daily activities of patients who have undergone TMJ arthroscopy. Methods: A prospective study was conducted in a Portuguese orofacial pain center with patients fulfilling the criteria for TMJ arthroscopy. For the first 30 days (D) after surgery, every 3 days, patients scored: (1) discomfort in the mastication of different food textures (soft, medium, hard); (2) time for a return to normal lifestyle (work, physical activities); and (3) TMJ pain during essential functions (mastication, speech, deglutition, deep breaths). The data were compared with preoperative results using descriptive statistics, one-way ANOVA, and the Friedman test. The level of significance was set at p < 0.05. Results: Forty-two patients were assessed for eligibility; fifteen did not meet the inclusion criteria, and five declined participation. Twenty-two patients initially started the study, but two canceled on days 6–18, and eleven patients tested positive for SARS-CoV-2. Nine female patients with sixteen operated joints completed the study. A progressive tolerance for scaling food textures was observed. Soft and medium textures were tolerated after D15 and D21, respectively. The hard texture was not well tolerated in the 30 days after surgery. Discomfort returning to work and practicing physical exercise was significantly reduced on D15 and D21, respectively. In addition, significant improvements in TMJ pain during mastication and speech were observed over time. Conclusions: Despite the study’s limitations, namely the small sample size, the non-validated questionnaire, and the non-biomechanical analysis of food texture, it was possible to observe after TMJ arthroscopy an early return to masticatory capacity with the progressive introduction of different food textures. The authors expect these results will help in future postoperative guidelines regarding postoperative recovery from TMJ arthroscopy.
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