摘要
目的:探讨颞下颌关节盘前移位双轴诊断的临床意义,评估关节腔注射联合牙合垫治疗颞下颌关节盘前移位的临床疗效。方法:选择诊断为颞下颌关节盘前移位患者28例,其中可复性关节盘前移位22例,不可复性关节盘前移位6例。采用SCL-90症状自评量表(Symptom Check List-90,SCL-90)评估就诊患者的心理健康状况,应用2%盐酸利多卡因联合透明质酸钠进行关节上腔的灌洗及注射治疗,制作上颌前导型再定位牙合垫并让患者佩戴。治疗后2周、4周、6周及3个月复查,评价其临床疗效。结果:SCL-90症状自评量表测量显示诊疗患者在躯体化、强迫症状、人际关系敏感、抑郁、焦虑、恐怖和精神病性的数值较全国常模数值偏高(P<0.05)。28例患者行关节上腔注射透明质酸钠与上颌前导型再定位牙合垫治疗后,2周、4周、6周及3个月均表现出显著疗效,与治疗前相比较,差异均有统计学意义(P<0.05),但治疗后3个月与治疗后6周相比较,差异无统计学意义(P>0.05)。结论:颞下颌关节盘前移位患者存在明显的心理健康方面的问题,应用透明质酸钠关节上腔注射联合上颌前导型再定位牙合垫治疗短期效果显著。
Objective：To investigate the clinical significance of dual-axis and clinical efficacy of articular cavity and occlusal splint on temporomandibular joint disc displacement. Methods：Twenty eight cases with anterior TMJ disc displace- ment with or without reduction were diagnosed by the MRI before process. Then Symptom Check List-90 scale（SCL-90） were used to measured mental health of the anterior TMJ disc displacement and all the patients were treated with anterior positio- ning appliance and articular cavity lavage of 2% lidocaine and injection of sodium hyaluronate. The clinical features were e- valuated before the treatment, after 2,4,6 weeks and 3 months. Results：The survey results of SCL-90 scales showed that all cases with anterior TMJ disc displacement got higher scores in somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, terrorist and psychotic symptoms than the patients of the general populations （ P 〈 0. 05 ）. It was distinct in the clinical efficacy of the twenty eight patients in the combination therapy of articular cavity injection and oc- clusal splint on anterior TMJ disc displacement. Compared to prior treatment, the clinical symptoms of all the patients bad been improved significantly after 2,4,6 weeks and 3 months（P 〈0. 05）. But there was no statistical difference of clinical ef- ficacy between 3 months and 6 weeks follow-up （P 〉 0.05 ）. Conclusion：The patients of anterior TMJ disc displacement have serious psychological problems, and it has approving and stable clinical efficacy in the patients of combination therapy of articular cavity injection and occlusal splint for short term.
出处
《临床口腔医学杂志》
2017年第6期350-353,共4页
Journal of Clinical Stomatology
关键词
颞下颌关节紊乱病
关节盘前移位
关节腔注射
垫
Temporomandibular joint disorders
Anterior disc displacement
Occlusal splint
