Prognostic factors in arthrocentesis of the temporomandibular joint: Evaluation of 100 patients with internal derangement
Prognostic factors in arthrocentesis of the temporomandibular joint: Evaluation of 100 patients with internal derangement
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DOI：
10.1053/joms.2001.25019
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发表时间：
2001-08-01
影响因子：
1.9
通讯作者：
Suzuki, T
中科院分区：
文献类型：
--
作者：
Nishimura, M;Segami, N;Suzuki, T
目的：本研究的目的是分析关节穿刺术成功治疗颞下颌关节 (TMJ) 内部紊乱 (ID) 的预后因素。 患者和方法：对 100 名 ID 患者的 103 例 TMJ 进行关节穿刺术作为初始治疗。根据术后最大张口范围（MMO）和术前视觉模拟评分（VAS）疼痛程度来评估治疗效果。分析的预后因素包括年龄、性别、锁定疼痛持续时间、术前和术后 MMO 范围、术前疼痛程度、术前锁定前张开嘴的声音以及磁共振成像 (MRI) 结果。对这些因素进行统计分析。结果：73例（71%）满足成功标准。手术后一周，成功病例的 MMO 平均范围 (43.8 +/- 5.5 mm) 显着大于不成功病例的平均范围 (36.9 +/- 6.6 mm) (P < .05)。成功病例术前 VAS 平均疼痛程度 (4.7 +/- 2.9) 显着小于不成功病例 (6.2 +/- 2.1) (P < .05)。成功病例术前MRI所见下颌髁突形态改变的发生率显着低于不成功病例（P < .05）。结论：术前剧烈疼痛、关节穿刺术后1周内张口量复发以及术前髁突骨性变化可能是关节穿刺术治疗TMJ ID有效性的预测因素。 (C) 2001 年美国口腔颌面外科医师协会。
Purpose: The goal of this study was to analyze the prognostic factors for successful arthrocentesis for internal derangement (ID) of the temporomandibular joint (TMJ).Patients and Methods: Arthrocentesis was carried out as the initial treatment in 103 TMJs of 100 patients with ID. The effectiveness of the treatment was evaluated in terms of the postoperative range of maximal mouth opening (MMO) and the degree of preoperative pain on a visual analog scale (VAS). Prognostic factors analyzed were age, sex, duration of painful locking, preoperative and postoperative range of MMO, preoperative degree of pain, preoperative clicking on opening mouth before becoming locked, and magnetic resonance imaging (MRI) findings. These factors were statistically analyzed.Results: Seventy-three cases (71%) satisfied the criteria for success. One week after the procedure, the mean range of MMO in the successful cases (43.8 +/- 5.5 mm) was significantly greater than that in unsuccessful cases (36.9 +/- 6.6 mm) (P < .05). The mean preoperative degree of pain on a VAS in successful cases (4.7 +/- 2.9) was significantly smaller than that in unsuccessful cases (6.2 +/- 2.1) (P < .05). The preoperative incidence of morphologic changes in the mandibular condyle seen on MRI of successful cases was significantly less than that in unsuccessful cases (P < .05).Conclusion: Severe preoperative pain, relapse in the amount of mouth opening within 1 week after arthrocentesis, and preoperative bony changes in the condyle may be predictors of the effectiveness of arthrocentesis for ID of the TMJ. (C) 2001 American Association of Oral and Maxillofacial Surgeons.