RW垫对改变正畸患者关节间隙的作用  

The effect of RW occlusal pad on the changes in the joint space of orthodontic patients with joint symptoms

作　　者：韩其庆 车宗刚[1] 宋永海[1] 徐晨[1] 文玉珍 Han Qiqing;Che Zonggang;Song Yonghai;Xu Chen ;Wen Yuzhen(Oral and Maxillofacial Surgery,Zibo Central Hospital Affiliated to Binzhou Medical College,Zibo 255036)

机构地区：[1]淄博市中心医院口腔颌面外科,淄博255036

出　　处：《口腔材料器械杂志》2018年第3期144-149,共6页Chinese Journal of Dental Materials and Devices

摘　　要：目的研究使用罗斯·威廉姆斯(Roth Williams,RW)垫对合并有关节症状的正畸患者的临床治疗效果,分析其对患者关节症状的疗效及其稳定性能,明确其对正畸诊断的作用,为正畸医师的整体治疗理念提供一定参考。方法回顾性分析于2015年5月至2016年11月在我院正畸科就诊并接受RW垫治疗的90例合并有关节症状患者的临床资料,治疗持续时间为6~13个月,观察患者治疗前后的临床症状和体征,应用CBCT测量,对比分析治疗前后颞下颌关节间隙的改变情况,评估其治疗效果及稳定性,分析髁突或者下颌位置的改变对于关节症状以及正畸诊断的影响。结果治疗后所有患者关节症状和体征改善明显,其中治愈66例,占73.33%;好转24例,占26.67%。。与治疗前相比,患者左右两侧的颞下颌关节前间隙、上间隙均变窄,左右关节后间隙、内侧间隙均增宽,且左侧前间隙与外侧间隙在治疗前后的改变以及右侧后间隙测量值的改变,差异均具有统计学意义(P<0.05)。治疗前患者中双侧颞下颌关节髁突后移位所占比例最高,为53.33%,其位置分布存在差异(P<0.05),治疗后患者髁突中位率增加,为50.00%,后移位比例(36.67%)低于治疗前。结论采用RW垫可以有效减小关节有害负荷,促进组织的修复与适应性的重造。Objectives To explore the clinical effects of RW-splint treatment on orthodontic patients with joint symptoms,to analyze the curative effect and stability of the joint symptoms,and to clarify its role in orthodontic diagnosis.Methods Retrospective analyses were performed based on clinical data of 90 orthodontic patients with joint symptoms from May 2015 to Nov.2016 in one hospital orthodontic department,to compare the clinical symptoms and signs,and the CBCT measurement result of temporomandibular joint space during RWsplint treatment,to analyze the curative effect and stability of joint symptoms,and to study the effect of condylar displacement on orthodontic diagnosis and joint symptoms.Results After treatment,joint symptoms and signs were improved significantly in all patients.66 cases were completely cured,at a rate of 73.33%,and 24 cases were mildly improved(26.67%).After treatment,the bilateral joint anterior and upper space was smaller,the posterior space and mesial space were increased;the change of anterior and lateral space in the left temporomandibular joint and the change of posterior space in the right temporomandibular joint during treatment were statistically significant(P<0.05).Before treatment,the rate of condyle retrodisplacement in bilateral joint was 53.33%,with statistically significant distribution(P<0.05).After the treatment,the median rate of condyle of patients was increased from 26.67%to 50.00%,the retrodisplacement rate was 36.67%,which was lower than that prior to treatment.Conclusion RW splint can reduce harmful joint load significantly and promote tissue repair and remake adaptability,and therefore can provide orthodontic doctors with some reference for the overall treatment.

关 键 词：RW(牙合)垫 关节症状 颞下颌关节功能紊乱综合征 关节间隙 

分 类 号：R783.5[医药卫生—口腔医学]