颞下颌关节盘穿孔两种治疗方法的疗效分析  

Treatment of temporomandibular joint disc perforation with injection of hyaluronic acid or disc repair

作　　者：陆金标[1] 龙星[1] 邓末宏[1] 程勇[1] 李波[1] 

机构地区：[1]武汉大学口腔医学院口腔颌面外科,430079

出　　处：《中华口腔医学杂志》2014年第8期476-480,共5页Chinese Journal of Stomatology

基　　金：国家自然科学基金（81271171）

摘　　要：目的 分析透明质酸（hyaluronic acid,HA）关节腔注射及关节盘修补术两种方法治疗颞下颌关节盘穿孔的效果.方法 随访分别采用透明质酸注射治疗的28例（38侧,HA组）及关节盘修补术治疗的20例（29侧,手术组）颞下颌关节盘穿孔患者,比较治疗前及治疗后3、9个月时最大开口度、疼痛及髁突骨质变化.结果 两组患者治疗后3及9个月开口度均较治疗前显著增大,HA组开口度增大平均5.89、7.64 mm;手术组增大2.75、6.10 mm,同时疼痛缓解,临床症状减轻,差异均有统计学意义（P＜0.05）.髁突有骨质修复性改建：HA组66％（25/38）,手术组55％（16/29）.结论 透明质酸注射及关节盘修补术均能有效缓解关节盘穿孔患者的临床症状.Objective To assess the efficacy of injection of sodium hyaluronate in the treatment of patients with disc perforation by using cone-beam computed tomography （CBCT） and temporomandibular joint （TMJ） function.Methods Twenty-eight patients （38 joints） with disc perforation observed through arthrography who received injection of sodium hyaluronate and other 20 patients （29 joints） who received disc repair were included in this study.Pain （visual analog scale,scores 0 to 100）,maximal mouth opening,modified Helkimo＆#39;s clinical dysfunction index and TMJ examinations with CBCT were obtained before and 3,9 months after treatment.Results A statistically significant increase （P〈0.05） in TMJ clinical outcome was observed at each follow-up.The maximal mouth opening （MMO） increased 5.89 mm and 7.64 mm at 3 and 9 months follow-up in the hyaluronic acid （HA） group,and the MMO increased 2.75 mm and 6.10 mm at 3 and 9 months follow-up in the operation group.Osseous remodeling occurred in 66% （25 of 38 joints） of patients after HA injection and 55%（16 of 29 joints） of patients appeared bone remodeling after disc repair.Conclusions Both injection of hyaluronic acid and disc repair are effective for treatment of temporomandibular joint disc perforation.

关 键 词：颞下颌关节 颞下颌关节盘 透明质酸注射 关节盘修补术 

分 类 号：R782.6[医药卫生—口腔医学]