颞下颌关节上腔灌洗术联合咬合板治疗老年颞下颌关节不可复性盘前移位效果分析  

Effect analysis of temporomandibular joint superior cavity lavage combined with occlusal plate in the treatment of irretrievable anterior disc displacement of temporomandibular joint in elderly patients

作　　者：李松 蔡琦 李军如[2] LI Song;CAI Qi;LI Jun-ru(Department of Stomatology,the 980th Hospital of the Joint Logistics Support Force of PLA,Shijiazhuang 050011,China)

机构地区：[1]中国人民解放军联勤保障部队第九八〇医院口腔科,石家庄050011 [2]石家庄市第二医院口腔科,050011

出　　处：《中华老年口腔医学杂志》2025年第1期53-57,共5页Chinese Journal of Geriatric Dentistry

基　　金：河北省2023年度医学科学研究课题计划(20231319)。

摘　　要：目的探讨颞下颌关节上腔灌洗术联合咬合板对颞下颌关节不可复性盘前移位(anteriordisc displacement without reduction,ADDWoR)老年患者的疗效。方法选取2023年1月至2023年12月白求恩国际和平医院收治的ADDWoR患者80例,均行颞下颌关节上腔灌洗术联合咬合板治疗,比较患者治疗前后最大张口度、面部疼痛、关节盘形态及关节渗液变化、下颌功能及生活质量,分析患者治疗后疗效。结果患者治疗后3、6个月最大张口度均高于治疗前,且患者治疗后6个月最大张口度高于治疗后3个月(P<0.05);患者治疗后3、6个月张口和咀嚼疼痛视觉模拟量表评分均低于治疗前,且患者治疗后6个月张口和咀嚼疼痛视觉模拟量表评分均低于治疗后3个月(P<0.05);治疗后6个月变形关节盘占比高于治疗前(98.75%vs91.25%,P<0.05),关节渗液检出率低于治疗前(2.50%vs 37.50%,P<0.01);患者治疗后6个月下颌功能限制评估量表评分、口腔健康影响程度量表各项及总评分低于治疗前(P<0.05,P<0.01);80例患者治愈8例,显效52例,有效17例,无效3例,治疗总有效率为96.25%。结论颞下颌关节上腔灌洗术联合咬合板能有效改善ADDWoR老年患者最大张口度、面部疼痛、关节盘形态及关节渗液,提高患者下颌功能及生活质量,疗效良好。Objective To investigate the efficacy of anterior disc displacement without reduction(ADDWoR)in elderly patients with superior temporomandibular joint lavage combined with occlusive plate.Methods Eighty patients with ADDWoR admitted to Bethune International Peace Hospital from January 2023 to December 2023 were selected,all of whom were treated with temporomandibular joint superior cavity lavage combined with occlusal plate.The maximum mouth opening,facial pain,articular disc morphology and exudation changes,mandibular function and quality of life were compared before and after treatment.Analyze the curative effect of patients after treatment.Results The maximal mouth opening(MMO)of the patients was higher at 3 and 6 months after treatment than before treatment,and the MMO was higher at 6 months after treatment than at 3 months after treatment(P<0.05).The scores of gaping and masticating pain at 3 and 6 months after treatment were lower than those before treatment,and the scores of gaping and masticating pain at 6 months after treatment were lower than those at 3 months after treatment(P<0.05).Six months after treatment,the proportion of deformed articular disc was higher than that before treatment(98.75%vs 91.25%,P<0.05),and the detection rate of joint exudation was lower than that before treatment(2.50%vs 37.50%,P<0.01).Six months after treatment,the scores of jaw functional limitation scale and oral health implant profile-14 were lower than those before treatment(P<0.05,P<0.01).Of the 80 patients,8 were cured,52 were markedly effective,17 were effective and 3 were ineffective.The total effective rate was 96.25%.Conclusion Temporomandibular joint upper cavity lavage combined with occlusal plate can effectively improve mouth opening,facial pain,joint disc shape and fluid seepage in elderly patients with ADDWoR,and improve mandibular function and quality of life.

关 键 词：颞下颌关节 不可复性盘前移位 关节上腔灌洗术 咬合板 疗效 疼痛 

分 类 号：R782.6[医药卫生—口腔医学]