透明质酸关节腔注射联合牙咬合板治疗颞下颌关节不可复性盘前移的疗效及美学效果评价  

Evaluation of the Curative Effect and Clinical Aesthetic Effect of Intra-articular Injection of Hyaluronic Acid Combined with Biteplate in the Treatment of Anterior Disc Displacement without Reduction

作　　者：苟学立 刘娥 侯大为[1] 刘瑞敏[1] GOU Xueli;LIU E;HOU Dawei;LIU Ruimin(Department of Oral and Maxillofacial Surgery,Gansu Provincial People's Hospital,Lanzhou 730000,Gansu,China;Department of Oral Medicine,Gansu Provincial People's Hospital,Lanzhou 730000,Gansu,China)

机构地区：[1]甘肃省人民医院口腔颌面外科,甘肃兰州730000 [2]甘肃省人民医院口腔内科,甘肃兰州730000

出　　处：《中国美容医学》2023年第9期125-129,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨透明质酸(Hyaluronic acid,HA)关节腔注射联合牙咬合板治疗颞下颌关节不可复性盘前移(Anterior disc displacement without reduction,ADDWoR)患者的疗效及临床美学效果。方法:选择2015年1月-2021年12月笔者医院口腔科门诊收治的100例ADDWoR患者,采用信封法将患者随机分为HA组和对照组,每组50例,对照组给予牙咬合板治疗,HA组予以HA关节腔注射联合牙咬合板治疗。比较两组患者疼痛视觉模拟评分(Visual analogue pain score,VAS)、颞下颌关节紊乱指数(Craniomandibular index,CMI)评分、下颌运动功能、临床美学指标及临床疗效。结果:治疗后,两组患者VAS、CMI评分均低于治疗前,且HA组显著低于对照组(P<0.05);两组患者最大主动开口度、左侧偏动距离、右侧偏动距离、下颌前伸距离均优于治疗前,且HA组显著优于对照组(P<0.05);两组患者髁突高度、关节腔间隙宽度均大于治疗前,且HA组显著大于对照组(P<0.05);治疗后HA组临床疗效有效率为82.00%,高于对照组的64.00%,差异有统计学意义(P<0.05)。结论:HA关节腔注射联合牙咬合板治疗ADDWoR,可有效缓解患者疼痛,改善其颞下颌关节紊乱情况及下颌运动功能,促进面型恢复,疗效显著,值得推广。Objective The aim of this study was to investigate the curative effect and clinical aesthetic effect of intra-articular injection of hyaluronic acid(HA)combined with biteplate in the treatment of anterior disc displacement without reduction(ADDWoR).Methods A total of 100 patients with ADDWoR who were admitted to the author’s hospital from January 2015 to December 2021 were selected,and they were randomly divided into a HA group and a control group by envelope method,50 cases in each group.Patients in the control group were treated with biteplate,and those in the HA group were treated with intra-articular injection of HA combined with biteplate.The pain Visual analogue scale(VAS)score,craniomandibular index(CMI)score,mandibular motor function,clinical aesthetic indicators and clinical effect were compared between the two groups.Results After treatment,the VAS scores and CMI scores of the two groups decreased,and the HA group had significantly lower scores than the control group(P<0.05).The maximal mouth opening,left displacement distance,right displacement distance,and mandibular extension distance were improved in the two groups,and these indicators in the HA group were significantly better than those in the control group(P<0.05).The condylar height and width of joint cavity in both groups increased,and the two in HA group were significantly larger than those in the control group(P<0.05).The clinical response rates in the HA group and the control group were 82.00%and 64.00%,respectively(P<0.05).Conclusion Intra-articular injection of HA combined with biteplate for treating ADDWoR can effectively relieve pain,improve temporomandibular disorder and mandibular motor function,and promote the recovery of facial shape,with significant effect.

关 键 词：透明质酸 牙咬合板 颞下颌关节紊乱病 不可复性盘前移位 

分 类 号：R782.6[医药卫生—口腔医学]