Long-term results and clinical evaluation of TMJ surgery for internal derangements of the temporomandibular joint.

颞下颌关节内部紊乱的颞下颌关节手术的长期结果和临床评估。

• 批准号: 08672299
• 负责人: MURAKAMI Kenichiro
• 金额: $ 1.41万
• 依托单位: KYOTO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08672299/
• 关键词: Temporomandibular; joint, Arthroscopic surqery; Open TMJ surgery

We investigated the long-term results of temporomandibular joint (TMJ) open surgery or arthroscopic surgery, and evaluated the functional outcome correlate to the stages of TMJ internal derangement after Wilkes in 1989.Arthroscopic surgery : Consecutive 56 joints in 41 patient were involved and assessed at least three-years to over five years (4.4 years in an average)follow-up basis. All patients rated their pain level in visual analogue scale, and filled pain, jaw dysfunction, and activity daily limiting questionnaire before, and postoperatives after the surgery. The patients's jaw opening was also scaled. The success rate was also calculated according to our success criteria based on above questionnaire. Results : The overall surgical success rate was 90.2%. In an subdivided staging groups, stage III group showed 85.7%, stage IV-91.7% and stage V-93.3%.Open surgery : Cumulative 38 joints in 31 patient were assessed at least five-years follow-up basis. The patients consisted with four intermittent locking cases, 22 closed locking cases, and fibe open locking cases. Long-term radiographic assessment revealed that there was acceptable bone remodeling, but there were no severe condylar resorption. Results : The overall success rate was 90.3%.Conclusion : Both TMJ arthroscopic and open surgery was considered as an effective and reliable surgery for various stage of internal derangement in a long run when appropriate nonsurgical treatment failed to cure the patient.

本文对1989年Wilkes手术后颞下颌关节内紊乱病进行了开放手术和关节镜手术的远期疗效观察，并对术后功能恢复情况进行了分析。关节镜手术：对41例56个关节进行了3年至5年以上（平均4.4年）的随访。所有患者术前、术后均采用视觉模拟评分法评定疼痛程度，并填写疼痛、下颌功能障碍、日常活动限制问卷。患者的下颌开口也被缩放。成功率也根据我们基于上述问卷的成功标准计算。结果：手术成功率为90.2%。在细分的分期组中，III期组为85.7%，IV期组为91.7%，V期组为93.3%。开放手术：31例患者累积38个关节至少随访5年。其中间断交锁4例，闭合交锁22例，开放交锁2例。长期影像学评估显示有可接受的骨重建，但没有严重的髁突吸收。结果如下：结论：关节镜下手术和开放手术治疗颞下颌关节内紊乱综合征，在非手术治疗无效的情况下，均是治疗颞下颌关节内紊乱综合征的有效方法。

项目成果

Hosaka H, Murakami K.et al: "Outcome of arthrocentesis for temporomandibular joint with celoged lock at 3 years follow-up." Oral Surg Oral Med Oral Pathol. 82. 501-504 (1996)

Hosaka H、Murakami K.等人：“颞下颌关节穿刺术 3 年随访结果。”

Hosaka H,Murakami K,Goto K,Iizuka T: "Outcome of Arthrocentesis for Temporomandibular Joint with Closed Lock at 3 Years Follow-up." Oral Surg Oral Med Oral Pathol.82. 501-504 (1996)

Hosaka H、Murakami K、Goto K、Iizuka T：“颞下颌关节闭合锁关节穿刺术 3 年随访结果”。

Furutani M,Murakami K,Hiraki S-I: "Magnetic resonance imaging after temporomandibular joint disckectomy. 78rd Annual Meeting and Scientific Sessions of American Association of Oral and Maxillofacial Surgeons. Sep, 1996. at Miami, U.S.A." J Oral Maxillofac

Furutani M、Murakami K、Hiraki S-I：“颞下颌关节盘切除术后的磁共振成像。美国口腔颌面外科医生协会第 78 届年会和科学会议。1996 年 9 月，美国迈阿密。”

村上賢一郎: "顎関節症に対する外科的治療の最近の進歩" 中・四国矯正歯科学会雑誌. 9. 9-13 (1997)

Kenichiro Murakami：“颞下颌关节疾病外科治疗的最新进展”中央四国正畸学会杂志 9. 9-13 (1997)。

Murakami K.et al.: "Four-Year Follow-up study of temporomeandibular Joint Arthroscopic surgery for Advauced stage Internal Derangements." J Oral Maxllofac Surg. 54. 285-290 (1996)

Murakami K.等人：“颞下颌关节镜手术治疗晚期内部紊乱的四年随访研究”。