手法复位结合稳定型咬合板治疗急性颞下颌关节盘不可复性前移位的疗效观察  

Therapeutic effect of stabilization splint combined with mandibular manipulation for treatment of acute anterior disc displacement without reduction

作　　者：朱梦然 魏煦[2] 孙卫斌[3] 朱锋[1] ZHU Mengran;WEI Xu;SUN Weibin;ZHU Feng(Department of Oral and Maxillofacial Surgery,Nanjing Stomatology Hospital,Medical School of Nanjing University,Nanjing 2100081 China)

机构地区：[1]南京大学医学院附属口腔医院口腔颌面外科,江苏南京210008 [2]南京大学医学院附属口腔医院口腔修复科,江苏南京210008 [3]南京大学医学院附属口腔医院牙周科,江苏南京210008

出　　处：《口腔医学》2021年第11期1000-1003,1051,共5页Stomatology

基　　金：南京市卫生青年人才培养工程(QRX17082);南京市医学科技发展项目(YKK18129)。

摘　　要：目的探讨对急性颞下颌关节盘不可复性前移位保守治疗的认识及治疗策略的选择。方法总结2018年5月—2020年5月本院颞下颌关节专科门诊诊治的20例急性颞下颌关节盘不可复性前移位患者,行手法复位结合稳定型咬合板治疗,3个月后对所有患者的关节盘复位情况和最大主动张口度进行评价,采用SPSS 24.0对数据进行检验分析。结果20例患者最大主动张口度明显改善,由治疗前的(27.15±5.91)mm增加到(41.35±4.82)mm;20例患者在治疗结束后复查MRI显示关节盘复位13例(占65%),仍然不可复性盘前移位7例(35%)。治疗3个月后最大主动张口度以及关节盘复位情况的比较,差异有统计学意义。结论手法复位结合稳定型咬合板治疗急性颞下颌关节盘不可复性前移位可以有效恢复患者张口度,改善关节功能以及对于恢复盘-髁关系有较明显的效果。Objective To explore the understanding of conservative treatment and the choice of treatment strategies of acute anterior disc displacement without reduction.Methods Twenty patients of acute anterior disc displacement without reduction with limited opening from May,2018 to May,2020 in the Department of Temporomandibular Joint,Nanjing Stomatological Hospital Medical School of Nanjing University,were included in the study.All patients received mandibular manipulation followed by occlusal splint therapy.After 3 months,the joint disc reduction and maximum active mouth opening of all patients were evaluated.SPSS 24.0 was used to test and analyze the data.Results The maximum active mouth opening of 20 patients was significantly improved,increasing from(27.15±5.91)mm to(41.35±4.82)mm;after treatment,MRI showed 13 cases(65%)of joint disc reduction in 20 patients,and 7 cases(35%)still had displacement without reduction.The difference between the maximum active mouth opening and the reduction of the joint disc after 3 months of treatment was statistically significant.Conclusion Mandibular manipulation combined with stabilization splint treatment of acute anterior disc displacement without reduction can effectively restore patients’mouth opening,improve joint function,and have a significant effect on the restoration of disc-condyle relationship.

关 键 词：颞下颌关节紊乱病 关节盘不可复性前移位 治疗策略 咬合板 手法复位 

分 类 号：R782.6[医药卫生—口腔医学]