稳定咬合板和再定位咬合板治疗青少年颞下颌关节盘间断性锁结的临床疗效评价  

Clinical effect of stabilization splint and anterior repositioning splint on treating intermittent closed lock

作　　者：石涛 张旭 吕俏 王飞 SHI Tao;ZHANG Xu;LUY Qiao;WANG Fei(Department of Prosthodontics,Dalian Stomatological Hospotal,Dalian 116000,China)

机构地区：[1]大连市口腔医院修复科,大连116000

出　　处：《口腔颌面修复学杂志》2021年第2期109-113,共5页Chinese Journal of Prosthodontics

基　　金：大连市医学科学研究计划项目(项目编号:1911084)。

摘　　要：目的:比较稳定咬合板和再定位咬合板进行治疗对于青少年颞下颌关节盘间断性锁结患者的临床应用疗效。方法:将40例青少年颞下颌关节盘间断性锁结患者,随机分为两组,分别戴用稳定咬合板和再定位咬合板进行治疗3-6个月,记录治疗前后关节疼痛指数、关节弹响及主动开口度;并比较MRI影像检查中关节盘-髁突距离在治疗前、后的变化。结果:两组治疗均可明显缓解关节疼痛和增加主动开口度,两组间没有显著性差异。稳定咬合板治疗组,治疗前疼痛指数为6.75±0.40,治疗后为2.80±0.20,治疗前开口度为27.20±1.20,治疗后为39.50±1.50;再定位咬合板治疗组,治疗前疼痛指数为6.50±0.20,治疗后为2.60±0.30,治疗前开口度为28.50±1.30,治疗后为40.60±1.40;在治疗关节弹响方面,戴用稳定咬合板的患者中大多数患者的关节弹响无明显改变,戴用再定位咬合板的患者中关节弹响得到了明显改善;MRI检查显示,再定位咬合板较稳定咬合板能更加明显的缩小患者的盘-突距离。戴用稳定咬合板治疗的患者,治疗前盘-突为6.34±2.13,治疗后为3.65±1.56;再定位咬合板治疗组,治疗前盘-突距离为6.45±2.15,治疗后为1.15±1.55。结论:稳定咬合板和再定位咬合板在缓解关节疼痛和增加张口度方面均有良好效果,在治疗关节弹响和恢复正常盘突出关系时,再定位咬合板效果较稳定咬合板更优,但本研究随访时间较短,两种咬合板的长期疗效还有待我们进一步发展观察分析研究。Objective:To compare the clinical effect of stabilization splint and anterior repositioning splint on treating intermittent closed lock.Methods:Ten patients with intermittent atresia were randomly divided into two groups with 30 patients in each group.Before and after treatment,the joint pain index,joint bounce and active opening degree were recorded,and the comparative study was conducted within and between groups.and the changes of disc condyle distance in MRI images before and after treatment were compared.Results:In terms of relieving joint pain and improving active opening,the two occlusal splints exerted good effects.There was no significant difference between the two groups(P>0.05).The pain index was 6.75±0.40 before treatment and 2.80±0.20 after treatment in patients with stabilization splint;the pain index was 6.50±0.20 before treatment and 2.60±0.30 after treatment in patients with anterior repositioning splint.The opening degree of patients with stabilization splint was 27.20±1.20 before treatment and 39.50±1.50 after treatment,and was 28.50±1.30 before treatment and 40.60±1.40 after treatment for patients with anterior repositioning splint.In the treatment of joint clicks,most patients with the stabilization splint had no significant change in joint clicks,and the joint clicks in patients with anterior repositioning splint was significantly improved,the difference between the two groups was statistically significant.MRI examination showed that anterior repositioning splint could significantly reduce the distance between the articular disc and condyle and restore the normal disc-condyle relationship.In patients treated with stabilization splint,the distance between the articular disc and condyle was 6.34±2.13 before treatment and 3.65±1.56 after treatment;in patients treated with anterior repositioning splint,the distance between the articular disc and condyle was 6.45±2.15 before treatment and 1.15±1.55 after treatment.Conclusion:For patients with intermittent temporomandibular atresia,sta

关 键 词：颞下颌关节盘绞锁 稳定咬合板 再定位咬合板 

分 类 号：R782.6[医药卫生—口腔医学]