Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan; Division of Oromaxillofacial Regeneration, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan.
Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan.
J Craniomaxillofac Surg. 2017 Nov;45(11):1772-1777. doi: 10.1016/j.jcms.2017.08.019. Epub 2017 Aug 24.
This study aimed to evaluate the relationship between displacement of the mandibular condyle/disc due to occlusal splint insertion with splint therapy and changes in discomfort of the temporomandibular joint (TMJ), and to clarify the relationships between the outcomes over time of temporomandibular discomfort and TMJ magnetic resonance imaging (MRI) findings at the initiation of splint therapy.
A total of 75 patients admitted to hospital with discomfort around the TMJ were evaluated. A visual analogue scale for TMJ discomfort was administered during visits for approximately 3 months following the initiation of splint therapy. At the start of splint therapy, magnetic resonance imaging (MRI) was performed with and without splint insertion, and condyle and disc movements were evaluated. Disc balance, disc position and function, disc configuration, joint effusion, osteoarthritis, and bone marrow were evaluated. Linear regression and multiple regression analyses were used to clarify relationships between changes in discomfort and the factors evaluated.
There was no significant correlation between TMJ discomfort and condyle/disc movement with splint insertion. TMJ discomfort was significantly relieved by splint therapy regardless of temporomandibular MRI findings. Unilateral anterior disc displacement and marked or extensive joint effusion fluid were significantly improved with splint therapy.
Discomfort tended to remit with splint therapy regardless of temporomandibular MRI findings. Improvement of TMJ discomfort appears more likely to occur in patients with unilateral anterior disc displacement and with an apparent organic disorder, such as a joint effusion.
本研究旨在评估因咬合夹板插入而导致的下颌髁/盘移位与夹板治疗后颞下颌关节(TMJ)不适变化之间的关系,并阐明夹板治疗开始时 TMJ 磁共振成像(MRI)结果与颞下颌不适随时间变化的关系。
共评估了 75 名因 TMJ 周围不适而住院的患者。在夹板治疗开始后约 3 个月的就诊期间,使用 TMJ 不适视觉模拟量表进行评估。在夹板治疗开始时,进行了带有和不带有夹板插入的 MRI,评估了髁突和关节盘的运动。评估了盘平衡、盘位置和功能、盘形态、关节积液、骨关节炎和骨髓。使用线性回归和多元回归分析来阐明不适变化与评估因素之间的关系。
TMJ 不适与夹板插入时的髁/盘运动之间无显著相关性。无论 TMJ MRI 结果如何,夹板治疗都能显著缓解 TMJ 不适。单侧前盘移位和明显或广泛的关节积液明显得到了夹板治疗的改善。
无论 TMJ MRI 结果如何,夹板治疗都可能缓解不适。TMJ 不适的改善似乎更可能发生在单侧前盘移位和存在明显的有机疾病(如关节积液)的患者中。