Long-term evaluation of arthrocentesis for the treatment of internal derangements of the temporomandibular joint
Long-term evaluation of arthrocentesis for the treatment of internal derangements of the temporomandibular joint
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DOI：
10.1053/joms.2000.8201
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发表时间：
2000-08-01
影响因子：
1.9
通讯作者：
Laskin, DM
中科院分区：
文献类型：
--
作者：
Carvajal, WA;Laskin, DM
目的：关节灌洗术用于治疗颞下颌关节紊乱病患者，包括关节盘前移位伴或不伴复位。本研究的目的是检查颞下颌关节arthrocentesis在这样的患者的长期影响，并评估他们的整体满意度与此treatment.Patients和方法：这项研究是基于审查患者的记录，书面问卷（自我评价），和临床检查。采用视觉模拟量表（VAS）评价疼痛和功能障碍。在弗吉尼亚联邦大学弗吉尼亚医学院医院接受治疗的26名患者（39个关节）被纳入本研究。关节盘前移位未复位（ADsR）32个，前移位复位（ADcR）7个。所有患者均在门诊接受关节穿刺术。随访时间为10 ~ 96个月，平均48.7个月。关节穿刺前最大垂直开口（MVO）范围为20至40 mm，平均为25.3 ± 5.5 mm。关节穿刺后即刻，MVO范围为30至55 mm，平均43.8 ± 5.6 mm。长期随访时的最大垂直开口范围为15 - 50 mm，平均值为37.1 ± 8.8 mm。无论是短期还是长期，（P <0.001）。与术前VAS值相比，术后疼痛和功能障碍的短期和长期VAS值显著降低（P <0.001）。26名患者中有14名（54%）不再出现疼痛，其余9名患者通过自我评估和临床检查评估疼痛比关节穿刺术前减轻。26名患者中有3名在一段时间内有所改善，后来复发，需要随后的手术。26名患者中有23名（88%）对治疗完全满意。总的来说，88%的成功率achieved.Conclusion：关节穿刺术可以减少疼痛和功能障碍，短期和长期，在椎间盘前移位的患者。(C)2000年美国口腔颌面外科医师协会。
Purpose: Arthrocentesis is being used for treatment of patients with temporomandibular joint disorders, including anterior disc displacement with and without reduction. This study was designed to examine the long-term effects of temporomandibular joint arthrocentesis in such patients and to evaluate their overall satisfaction with this treatment.Patients and Methods: The study was based on the review of patients' records, a written questionnaire (self-evaluation), and clinical examination. Visual analog scales (VAS) were used for evaluation of pain and dysfunction. Twenty-six patients (39 joints) who had been treated at the Medical College of Virginia Hospital, Virginia Commonwealth University, were included in the study. There were 32 joints with anterior disc displacement without reduction (ADsR) and 7 joints with anterior displacement with reduction (ADcR). Patients all had undergone arthrocentesis as outpatients. Follow-up evaluations ranged from 10 to 96 months, with a mean of 48.7 months.Results: Maximum vertical opening (MVO) prearthrocentesis ranged from 20 to 40 mm, with a mean of 25.3 +/- 5.5 mm. Immediately after arthrocentesis, the MVO ranged from 30 to 55 mm, with a mean of 43.8 +/- 5.6 mm. Maximum vertical opening at long-term follow-up ranged from 15 to 50 mm, with a mean of 37.1 +/- 8.8 mm. There was a significant increase in MVO between prearthrocentesis and postarthrocentesis both short- and long-term (P < .001). The short- and long-term postoperative VAS values for pain and dysfunction showed a significant decrease (P < .001) when compared with the VAS values preoperatively. Fourteen of the 26 patients (54%) no longer experienced pain, and the remaining 9 had less pain than before arthrocentesis as assessed by self-evaluation and clinical examination. Three of 26 patients had improvement for a period, later relapsed, and required subsequent surgery. Twenty-three of the 26 patients (88%) were completely satisfied with their treatment. Overall, an 88% success rate was achieved.Conclusion: Arthrocentesis can reduce pain and dysfunction, both short- and long-term, in patients with anterior disc displacement. (C) 2000 American Association of Oral and Maxillofacial Surgeons.