Assessment of Occlusal Appliance for the Reposition of Temporomandibular Joint Anterior Disc Displacement With Reduction
Assessment of Occlusal Appliance for the Reposition of Temporomandibular Joint Anterior Disc Displacement With Reduction
复制标题
颞下颌关节前盘移位复位复位咬合矫治器的评估
DOI：
10.1097/scs.0000000000005210
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发表时间：
2019
影响因子：
0.9
通讯作者：
Yang Chi
中科院分区：
文献类型：
--
作者：
Shen Pei;Chen Xinwei;Xie Qianyang;Zhang Shanyong;Yang Chi
本研究的目的是评估患者使用咬合矫正器复位颞下颌关节盘前移位复位（ADDWR）的成功率和成功率。我们的研究纳入了144例连续患者（210个关节）的样本，这些患者根据MRI诊断为ADDWR。基于磁共振成像（MRI），在下颌前部位置确认椎间盘回收，以消除关节咔嗒声。应用前复位矫治器（ARS）将下颌骨保持在该位置。大约每4周将ARS的咬合面研磨1 mm以进行咬合重建。在治疗前、治疗开始后6个月、治疗结束时和末次随访时进行MRI检查。使用考克斯回归模型估计治疗失败的风险。平均治疗时间为9.5±2.6个月。根据MRI，共有177个关节（84.3%）在夹板治疗结束时成功复位。定期随访表明，近53%的患者在2年后具有正常的椎间盘-髁突关系。最终的考克斯回归模型包括性别、年龄、治疗持续时间和使用的药物，风险比分别为1.375、1.141、0.396和0.364。从长期来看，ARS对于ADDWR的夺回是不利的。因此，更好地探索其他更有效的方法来复位ADDWR患者的移位椎间盘。
The aim of our study was to evaluate the success rates and prognoses of patients treated with occlusal appliances used to reposition the temporomandibular joint anterior disc displacement with reduction (ADDWR). A sample of 144 consecutive patients (210 joints) diagnosed with ADDWR based on MRI were included in our study. Disc recapture was confirmed in a mandible-anterior position to eliminate joint clicking based on magnetic resonance imaging (MRI). Anterior repositioning appliance (ARS) was applied to keep the mandible in this position. The occlusal surface of the ARS was ground down by 1 mm approximately every 4 weeks for bite reconstruction. MRI was carried out before treatment, 6 months after the start of treatment, at the end of the treatment, and at their last follow-up visit. A Cox regression model was used to estimate the risk of failure of the treatment. The mean treatment duration was 9.5±2.6 months. A total of 177 joints (84.3%) were successfully repositioned at the end of splint treatment according to MRI. Regular follow-up indicated that almost 53% of the patients had normal disc–condyle relationships after 2 years. Sex, age, treatment duration, and orthodontics used were included in the final Cox regression model, with hazard ratios of 1.375, 1.141, 0.396, and 0.364, respectively. ARS is inferior for recapturing ADDWR in the long-term. It is thus better to explore other more effective methods to reposition the displaced disc in patients with ADDWR.