口腔医学研究

口腔医学研究 ›› 2019, Vol. 35 ›› Issue (6): 583-586.DOI: 10.13701/j.cnki.kqyxyj.2019.06.017

• 颞下颌关节与创伤学研究 • 上一篇    下一篇

颞下颌关节骨关节病3种保守治疗的锥形束CT评价

李菁1,龙星2*,林妍华1,刘海鹏3,周建平1   

  1. 1. 兰州市口腔医院颌面外科 甘肃 兰州 730000;
    2. 武汉大学口腔医院颌面外科 湖北 武汉 430079;
    3. 兰州市口腔医院放射科 甘肃 兰州 730000
  • 收稿日期:2018-10-13 出版日期:2019-06-28 发布日期:2019-06-27
  • 通讯作者: 龙星,E-mail:longxing@whu.edu.cn
  • 作者简介:李菁(1973~ ),女,四川人 ,硕士,主任医师,研究方向:颞下颌关节。
  • 基金资助:
    兰州市创新创业项目(编号:2016-RC-36)

CBCT Evaluation of Three Conservative Treatment Methods for Temporomandibular Joint Osteoarthrosis

LI Jing1, LONG Xing2*, LIN Yan-hua1, LIU Hai-peng3, ZHOU Jian-ping1   

  1. 1. Department of Oral and Maxillofacial Surgery, Lanzhou Hospital of Stomatology, Lanzhou 730000, China;
    2. Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China;
    3. Department of Radiology, Lanzhou Hospital of Stomatology, Lanzhou 730000, China.
  • Received:2018-10-13 Online:2019-06-28 Published:2019-06-27

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摘要： 目的:采用随机对照方法比较3种保守治疗对髁突骨质的影响,为颞下颌关节骨关节病治疗提供影像学依据。方法:90例患者随机分为3组,给予不同保守治疗方法。通过治疗前、治疗后3个月和9个月锥形束CT(cone beam computer tomography,CBCT)影像学检查及临床检查,从髁突形态变化、疼痛度、最大开口度、Fricton指数观察稳定型牙合垫治疗、关节上腔注射治疗、稳定型牙合垫+关节上腔注射治疗的治疗效果。结果:CBCT显示稳定型牙合垫+关节上腔注射治疗组在治疗后3个月和9个月与关节上腔注射治疗组和稳定型牙合垫治疗组比较髁突骨质明显改建,骨面平整光滑,骨赘减小(P<0.05 ),3组患者Fricton指数、疼痛度、最大开口度在治疗后3个月和9个月比较差异无统计学意义(P>0.05)。结论:稳定型牙合垫+关节上腔注射治疗可促进已破坏髁突表面骨质改建,其效果明显优于单纯牙合垫治疗组和关节上腔注射治疗组。

关键词: 颞下颌关节骨关节病, 稳定型牙合垫, 透明质酸钠, 锥形束CT

Abstract: Objective: To assess the changes of condylar morphology in different conservation treatments through systematic review of relevant randomized controlled trials, and to provide image evidence for the treatment of temporomandibular joint osteoarthrosis. Methods: 90 patients were randomly divided into 3 groups and given different conservative treatments. The condylar morphology and clinical symptoms were evaluated after 3 months and 9 months. The clinical parameters recorded were Fricton′s Craniomandibular index (CMI), maximal mouth opening (MMO), pain intensity on a visual analog scale (VAS), and CBCT radiographic data of 113 TMJs from 90 consecutive TMJ patients. Results: The surface of the condyle became smooth, the density of the cortical bone and the adjacent subcortical bone increased and osteophyte in condylar head decreased after 9 months treatment. In terms of the changes of the condylar bone, the group of joint injection plus stabilization splint were better than the other group (P<0.05). CMI, MMO, and VAS were significant decreased after 3 months and 9 months, but there were no significant differences among three groups (P>0.05). Conclusion: Joint injection plus stabilization splint can promote the bone remodeling on the surface of condyle. Comparing to the other conservative treatment, it is an appropriate treatment for temporomandibular joint osteoarthrosishe.

Key words: Temporomandibular joint steoarthrosis, Sodium hyaluronate, Stabilization splint, Cone-beam computed tomographic