尖牙保护性咬合板治疗颞下颌关节盘前移位的疗效评估  

Efficacy of canine-protected splint on treatment of anterior disc displacement of temporomandibular joint

作　　者：芮娜[1] 张建华[1] 薛昌敖[1] 刘林栋[2] 吴刚[2] 

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)口腔科,主治医师江苏210006 [2]南京医科大学附属南京医院(南京市第一医院)放射影像科,主管技师江苏210006

出　　处：《口腔颌面修复学杂志》2014年第6期331-334,共4页Chinese Journal of Prosthodontics

基　　金：南京市医学科技发展基金(项目编号:YKK09059)

摘　　要：目的:观察尖牙保护性咬合板对颞下颌关节盘前移位的治疗效果,探讨3.0T磁共振成像(MRI)在疗效评估中的作用。方法:以经临床和MRI检查诊断为颞下颌关节盘紊乱病盘前移位的16例患者共26侧关节作为研究对象,接受尖牙保护性咬合板治疗,疗程为3-4个月,治疗前后,测量张口度评估下颌运动功能;视觉模拟评分法(VAS)评估疼痛程度(VAS评分),并复查3.0T MRI并与治疗前进行比较。结果:治疗结束后,患者VAS评分平均为2.08±1.65,显著小于治疗前的7.19±1.58(P<0.001);张口度平均为(36.13±5.97)mm,明显大于治疗前的(25.15±6.02)mm(P<0.001)。与治疗前比较,治疗结束后21侧关节的MRI表现变化不明显,仅有5侧关节的MRI表现有明显改变,均显示为关节腔积液减少或消失,其中3侧可复性关节盘前移位的关节盘回复至基本正常位置,另2侧不可复性关节盘前移位,恢复为可复性关节盘前移位。结论:尖牙保护性咬合板治疗颞下颌关节盘前移位能明显减轻疼痛,改善下颌运动功能,MRI表现不能作为评估咬合板疗效的单一标准。Objective： To investigate the efficacy of canine-protected splint in treatment of anterior disc displacement of temporomandibular joint, and to explore the role of 3.0T MRI in evaluation of the therapeutic effect. Methods： 26 joints （from 16 patients） of anterior disc displacement of temporomandibular joint diagnosed by MRI were chosen for treatment of canine-protected splint for the period of 3-4 months. Before and after treatment, mandibular movement function was as- sessed by oral opening distance, visual analogue scale （VAS） score was obtained, and a second 3.0T MRI was performed to compare with the findings before treatment. Results： After treatment, the mean VAS score was 2.08 （± 1.65）, and was sig- nificantly lower than that before treatment 7. 19 （± 1.58） （P〈 0.001）. The mean oral opening distance was 36.13 （± 5.97） mrn, and was significantly larger than that before treatment 25.15 （± 6.02） mm （P〈 0.001）. Compared to those before treat- ments, the MRI findings of the 21 joints after treatment did not show significantly different, while only five joints showed significant different with reduced arthroedema. Three of the five joints showed a reposition of the articular discs to normal position, and two of them showed a reversible articular disc displacement from irreversible articular interlocking. Conclu- sion： Canine-protected splint could significantly relieve the pain and improve the mandibular movement fimction in the treatment of anterior disc displacement of temporomandibular joint, and 3.0T MRI would not be the only criterion on evalu- ation of the therapeutic effect.

关 键 词：咬合板 关节盘移位 磁共振成像 

分 类 号：R782.6[医药卫生—口腔医学]