中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2023, Vol. 21 ›› Issue (4): 397-402.doi: 10.19438/j.cjoms.2023.04.013

• 论著 • 上一篇    下一篇

双线锚固钉在颞下颌关节盘锚固术中的应用效果评价

吾尔古丽·阿力甫1,2, 热伊莱·阿不都克热木1,2, 柳江龙1,2, 买买提吐逊·吐尔地1,2   

  1. 1.新疆医科大学第一附属医院（附属口腔医院） 口腔颌面创伤正颌外科,新疆 乌鲁木齐 830054;
    2.新疆维吾尔自治区口腔医学研究所,新疆 乌鲁木齐 830054
  • 收稿日期:2022-12-10 修回日期:2023-01-20 出版日期:2023-07-20 发布日期:2023-08-16
  • 通讯作者: 买买提吐逊·吐尔地,E-mail：maimaitituxun@aliyun.com
  • 作者简介:吾尔古丽·阿力甫（1993-）,女,在读硕士研究生,E-mail：lesehor@163.com

Evaluation of the application of double wire anchor nails in temporomandibular joint disc anchorage

WUERGULI Alifu1,2, REYILAI Abudukeremu1,2, LIU Jiang-long1,2, MAIMAITITUXUN Tuerdi1,2   

  1. 1. Department of Oral and Maxillofacial Trauma and Orthognathic Surgery, First Affiliated Hospital (Stomatological Hospital) of Xinjiang Medical University. Urumqi 830054;
    2. Institute of Stomatology, Xinjiang Uygur Autonomous Region. Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Received:2022-12-10 Revised:2023-01-20 Online:2023-07-20 Published:2023-08-16

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摘要： 目的：评价双线锚固钉在颞下颌关节盘锚固术（disc anchorage,DA）的应用效果。方法：选择2021年6月—2022年2月于新疆医科大学第一附属医院就诊的30例（30侧关节）诊断为颞下颌关节盘不可复性前移位（ADDWoR）的患者,在颞下颌关节盘锚固术中应用双线锚固钉进行复位固定关节盘,对患者术前、术后不同时段的最大开口度和疼痛视觉模拟量表（VAS）评分进行分析,记录患者自我疗效满意度以及测量手术前后MRI关节盘长度及髁突高度。采用SPSS 25.0软件包对数据进行统计学分析。结果：患者平均年龄（24.43±8.87）岁,术前平均开口度为（29.17±5.38）mm（19~42 mm）,术后为（39.17±2.57）mm（35~45 mm）,术后93.3%的患者最大开口度>35 mm;VAS评分值术前为58.33±21.19,术后6个月为11.67±6.99,术后6个月的开口度及VAS值与术前相比有显著差异（P<0.05）。术前、术后即刻及术后6个月MRI测量关节盘长度分别为（9.77±0.63）、（11.96±0.68）和（12.72±0.55）mm;术后6个月与术后即刻相比,髁突高度增加（1.08±0.61）mm（P<0.05）。结论：对于颞下颌关节盘不可复性前移位,在关节盘复位锚固术中应用双线锚固钉,在改善开口度、缓解关节疼痛、关节盘长度和髁突高度增加对关节盘位置改变及其重新定位后髁突改建等方面,均取得可靠的临床效果。

关键词: 锚固钉, 关节盘锚固术, 颞下颌关节盘不可复性前移位

Abstract: PURPOSE: To evaluate the clinical efficacy of double wire anchorage in the treatment of temporomandibular joint disc anterior displacement. METHODS: Thirty patients with anterior disc displacement without reduction(ADDWoR) diagnosed in First Affiliated Hospital of Xinjiang Medical University from June 2021 to February 2022 were included to fix the discs with double wire anchors. The maximal open mouth, visual analogue scale (VAS) scores of the patients before and at different time periods were analyzed, the patients' self-satisfaction was recorded, and the length of MRI discs and condylar height before and after operation were measured. SPSS 25.0 software was used to analyze the data and evaluate the surgical results. RESULTS: The mean age was 24.43±8.87 years old, the mean mouth opening before operation was (29.17±5.38) mm (19-42 mm), the mean maximum mouth opening after operation was (39.17±2.57) mm (35-45 mm), and 93.3% of the patients after operation had the maximum mouth opening >35 mm; the mean VAS before operation was 58.33±21.19 (10-90), the mean VAS 6 months after operation was 11.67±6.99(0-20), the mouth opening and the value of VAS 6 months after operation had significant difference compared with prior to operation(P<0.05). The disc length was (9.77±0.63), (11.96±0.68) and (12.72±0.55) mm preoperatively, immediately postoperatively and 6 months after surgery. The condyle height increased by (1.08±0.61) mm 6 months after surgery compared with immediately postoperatively (P<0.05). CONCLUSIONS: Double wire anchorage in the reduction and anchorage of TMJ disc can improve the mouth opening, relieve pain, increase the length of TMJ disc and increase the height of condyle.

Key words: Anchor nail, Disc Anchorage, Anterior disc displacement without reduction

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