Yang's Classification of Juvenile TMJ Anterior Disc Displacement Contributing to Treatment protocols
Yang's Classification of Juvenile TMJ Anterior Disc Displacement Contributing to Treatment protocols
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Yang 对青少年颞下颌关节前椎间盘移位的分类对治疗方案的贡献
DOI：
10.1038/s41598-019-42081-5
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发表时间：
2019-04-04
影响因子：
4.6
通讯作者：
Yang, Chi
中科院分区：
文献类型：
--
作者：
Shen, Pei;Xie, Qianyang;Yang, Chi
本研究旨在建立一种新的颞下颌关节盘前移位（ADD）分期系统，并评价其在指导治疗计划中的作用。纳入并分析了基于磁共振成像（MRI）诊断为ADD的522例青少年患者（780个关节）的连续样本。根据我们的分期系统，674个关节接受了TMJ治疗，而106个关节拒绝任何治疗;仅用于随访。结果根据我们的成功标准进行判断。我们的分期系统的预后也进行了评估比较Wilkes分类。Kaplan-Meier生存分析显示，在我们的分期系统中的任何两个阶段内的所有亚组中，除0和1期，2和3期，3和4期之间的亚组外，均发现了改善率的显著分层。在分析了考克斯模型中不同候选预后因素之间的相互作用后，ADD恶化的相对风险包括治疗方法（HR = 42.94，P < 0.0001），病程（HR = 0.98，P = 0.0019），ADD分期（2期、3期、4期HR分别为3.81、9.62、12.14，P= 0.016、0.000、0.000）以及ADD分期与治疗方法之间的交互作用。该模型的C指数为0.87。新的TMJ ADD分期方法可靠，有利于制定治疗方案和预测预后。
This study aims to establish a new staging system of temporomandibular joint (TMJ) anterior disc displacement (ADD) and evaluate its role in guiding the treatment plan. A consecutive sample of 522 juvenile patients (780 joints) diagnosed as ADD based on magnetic resonance imaging (MRI) was included and analyzed. 674 joints received TMJ treatments according to our staging system, while 106 joints rejected any treatment; only for follow-up. The outcomes were judged according to our success criteria. The prognosis of our staging system was also evaluated in comparison to Wilkes classification. Kaplan-Meier survival analysis showed that significant stratifications of the ameliorative rate were found at all subgroups within any two stages in our staging system, except for subgroups between stages 0 and 1, stages 2 and 3, and stages 3 and 4. After analyzing the interactions between different candidate prognostic factors in a Cox model, the relative risks of deterioration of ADD included treatment methods (HR = 42.94, P < 0.0001), disease course (HR = 0.98, P = 0.0019), stages of ADD (HR =3.81, 9.62, 12.14, P= 0.016, 0.000,0.000 respectively for stage 2, stage 3 and stage 4) and the interaction between ADD stages and treatment methods. The C index of this model was 0.87. The new staging system of TMJ ADD appears reliable, and benefits to making treatment planning and predicting the prognosis.