颞下颌关节急性不可复性盘前移位复位后改良前牙咬合板联合再定位咬合板维持的疗效初步评估  

Preliminary evaluation of modified anterior splint combined with anterior repositioning splint after successful mandibular manipulation in treatment of acute anterior disc displacement without reduction of temporomandibular joint

作　　者：黄超 吴兴胜 湛圳 张林[1] 石连水[1] Huang Chao;Wu Xingsheng;Zhan Zhen;Zhang Lin;Shi Lianshui(Jiangxi Provincial Key Laboratory of Oral Diseases&Jiangxi Provincial Clinical Research Center for Oral Diseases&Dept.of Prosthodontics,The Affiliated Stomatological Hospital,Nanchang University,Nanchang 330000,China)

机构地区：[1]口腔疾病江西省重点实验室江西省口腔疾病临床医学研究中心,南昌大学附属口腔医院口腔修复科,南昌330000

出　　处：《华西口腔医学杂志》2025年第2期262-268,共7页West China Journal of Stomatology

摘　　要：目的利用磁共振成像(MRI)观察改良前牙咬合板(MAS)联合再定位咬合板(ARS)维持协调盘-髁关系的疗效。方法收集2024年1—6月就诊于南昌大学附属口腔医院,手法复位成功的10例颞下颌关节急性不可复性盘前移位(ADDwoR)患者的临床及影像学资料。每位患者在复位后使用MAS和ARS治疗,分别在治疗前,治疗2周、1月、3月后记录患者的最大主动开口度(MMO)和疼痛视觉类比评分(VAS)。通过MRI分析治疗前、治疗3个月后盘-髁关系、盘-髁角度、关节积液及双线征的变化。结果经3个月治疗,患者临床症状明显改善,MMO由治疗前的28.90 mm增加到46.85 mm,VAS值由治疗前的4.68降至0.61。MRI显示,6例盘-髁关系正常,2例为可复性盘前移位,2例为ADDwoR,盘-髁角度由治疗前的58.84°降低至25.99°。结论急性ADDwoR在手法复位成功后,MAS联合ARS能有效维持正常的盘-髁关系。Objective Magnetic resonance imaging(MRI)was used to study the efficacy of modified anterior splint(MAS)combined with anterior repositioning splint(ARS)in maintaining the normal disk-condyle relationship.Methods We obtained clinical and imaging data of 10 patients with acute anterior disk displacement without reduction(ADDwoR)of the temporomandibular joint undergoing successful mandibular manipulation in the Affiliated Stomatological Hospital,Nanchang University from January to June 2024.The MAS and ARS were used for subsequent treatment.Maximum active mouth opening(MMO)and visual analogue score(VAS)were recorded before treatment and 2 weeks,1 month,and 3 months after treatment.The changes in the disk-condyle relationship,disk-condyle angle,joint effusion,and double contour sign before and after treatment were analyzed through MRI.Results Three months after treatment,the MMO increased from 28.90 mm to 46.85 mm,VAS decreased from 4.68 to 0.61,and the disk-condyle angle decreased from 58.84°to 25.99°.MRI analysis found that 6 patients showed normal disk-condyle relationship,2 patients exhibited displacement with reduction,and 2 patients exhibited ADDwoR.The disk-condyle angle was 58.84°before treatment and 25.99°after treatment.Conclusion The MAS combined with ARS could further stabilize the coordinated disk-condyle relationship and reduce the recurrence rate.

关 键 词：颞下颌关节紊乱病 手法复位 再定位咬合板 不可复性盘前移位 

分 类 号：R782.6[医药卫生—口腔医学]