不可复性盘前移位颞下颌关节镜术后垫治疗评价  

The Clinical Comparative Study of Arthroscopic Surgery Combined with or without Occlusion Splint in the Treatment of the Anterior Disc Displacement Without Reduction

作　　者：冼淡[1] 陈巨峰[1] 莫础嘉[1] 方溢云[1] 劳均平[1] 王光护[1] 

机构地区：[1]佛山市第一人民医院口腔科,广东佛山528000

出　　处：《广东牙病防治》2005年第1期25-27,共3页Journal of Dental Prevention and Treatment

摘　　要：目的　对比评价关节镜手术加或不加牙合垫治疗颞下颌关节盘不可复性前移位的效果。方法　一组(40例 )应用关节镜手术 (灌洗加松解术 )治疗关节盘不可复性前移位 ,另一组 (40例 )则在关节镜手术后配合牙合垫治疗。结果　随访 2年 ,术后 3个月时两组患者 (VAS法 )疼痛缓解程度均值分别为 1.8、2 .5 ,6个月时分别为 3.2、4 .8,1年时分别为 5 .6、5 .8,2年时分别为 6 .0、6 .2 ;张口度增加均值分别为 3个月时 5 .6mm、7.8mm ,6个月时为8.2mm、9.7mm ,1年时为 9.4mm、9.8mm ,2年时为 9.7mm、10 .2mm ,其中术后 3、6个月时疼痛及张口度改变均具有统计学意义 (P <0 .0 1) ,而 1年、2年时疼痛、张口度改变对比均不具显著性差异。结论　关节镜下行灌洗加松解术 ,并行牙合垫治疗关节盘不可复性前移位短期疗效 (3～ 6个月 )较单纯采用关节镜下行灌洗加松解术效果好 ,而术后 1～ 2年疗效差异不大。Objective To evaluate the effect of two procedures on the treatment of anterior disc displacement without reduction (ADDWR) of TMJ. Methods 80 patients with ADDWR were classfied into two groups. One was treated by arthroscopic surgical lysis and lavage only, the other received additional splint therapy after the arthroscopic surgery. Results The mean pain relief degree of both groups was 1.8 and 2.5 respectively in three months (P>0.01) after the operation, 3.2 and 4.8 in six months (P<0.01), 5.6 and 5.8 in a year (P>0.01), 6.0 and 6.2 in two years (P>0.01). The mean mouth-opening degree was 5.6 and 7.8 mm respectively in three months (P>0.01) after the operation, 8.2 and 9.7 in six months (P<0.01), 9.4 and 9.8 in a year (P>0.01), 9.7 and 10.2 in two years (P<0.01). Conclusion In the treatment of ADDWR, arthroscopic surgery plus splint therapy is better than that without splint therapy in short term, but no different effect was found in the long term.

关 键 词：治疗 HE垫 术后 张口度 松解术 灌洗 关节镜手术 移位 对比 差异 

分 类 号：R782[医药卫生—口腔医学] R783[医药卫生—临床医学]