中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2026, Vol. 24 ›› Issue (1): 17-22.doi: 10.19438/j.cjoms.2026.01.003

• 论著 • 上一篇    下一篇

前伸再定位垫治疗颞下颌关节盘可复性前移位的效果及影响因素分析

李敏涵, 张楚晗, 朱妍, 何佳颖, 杨驰*, 马志贵*   

  1. 上海交通大学医学院附属第九人民医院 口腔外科,上海交通大学口腔医学院,国家口腔医学中心,口腔疾病国家临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,中国医学科学院口腔颌面再生医学创新单元,上海 200011
  • 收稿日期:2025-06-14 修回日期:2025-07-07 发布日期:2026-02-06
  • 通讯作者: 杨驰,E-mail: yangchi63@hotmail.com;马志贵,E-mail: mazhigui1984@163.com。*共同通信作者
  • 作者简介:李敏涵（2000-）,女,硕士研究生,E-mail: liminhanliminhan@163.com
  • 基金资助:
    上海交通大学医学院附属第九人民医院优秀青年基金（JYYQ016）; 上海交通大学医学院附属第九人民医院院级教医学教育研究项目（JYJX03202310,JYJX03202414,JYJX03202502）; 上海交通大学医学院附属第九人民医院横向科研项目（KQHX2025-06,KQHX2024-05）

Analysis of the efficacy and influencing factors of anterior repositioning splint in the treatment of temporomandibular joint anterior disc displacement with reduction

Li Minhan, Zhang Chuhan, Zhu Yan, He Jiaying, Yang Chi, Ma Zhigui   

  1. Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; School of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences. Shanghai 200011, China
  • Received:2025-06-14 Revised:2025-07-07 Published:2026-02-06

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摘要： 目的: 探讨前伸再定位垫（anterior repositioning splint,ARS）治疗可复性关节盘前移位（anterior disc displacement with reduction, ADDWR）的疗效及影响因素,为临床治疗选择提供参考。方法: 纳入2009年1月—2018年6月上海交通大学医学院附属第九人民医院接受ARS治疗的58例ADDWR患者,根据治疗结束后6个月的关节盘复位效果分为成功组（40例）和失败组（18例）,比较两组治疗初期的临床特征及头影测量指标,通过多因素logistic回归筛选影响治疗效果的独立因素。结果: 失败组治疗初期的颏点偏斜程度显著大于成功组（P<0.001）,Sn-G Vert距（P<0.05）及S Vert-Co距（P<0.001）显著小于成功组。多因素 logistic 回归显示,颏点偏斜（OR=0.12,95%CI=0.03~0.58）、S Vert-Co 距（OR=2.53,95%CI=1.128~5.67）及 Sn-G Vert 距（OR=4.67,95%CI=1.14~19.09）是 ARS 疗效的独立影响因素（P<0.05）。结论: 患者治疗初期的颏点偏斜程度、S Vert-Co距及Sn-G Vert距是ARS治疗ADDWR疗效的关键指标,临床上可结合这些指标评估预后并优化治疗方案。

关键词: 颞下颌关节盘可复性前移位, 前伸再定位垫, 复位效果, 颏点偏斜, 影响因素

Abstract: PURPOSE: To explore the efficacy of anterior repositioning splint(ARS) in the treatment of anterior disc displacement with reduction(ADDWR) and its influencing factors, so as to provide reference for clinical treatment selection. METHODS: A total of 58 ADDWR patients who received ARS treatment in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2009 to June 2018 were included. According to the effect of articular disc reduction 6 months after the end of treatment, they were divided into the success group(n=40) and the failure group(n=18). The initial clinical characteristics and cephalometric indexes of the two groups were compared, and the independent influencing factors of treatment effect were screened by multivariate logistic regression. RESULTS: In the initial stage of treatment, the degree of chin deviation in the failure group was significantly greater than that in the success group (P<0.001), while the Sn-G Vert distance (P<0.05) and S Vert-Co distance (P<0.001) were significantly smaller than those in the success group. Multivariate logistic regression showed that chin deviation(OR=0.12, 95%CI=0.03-0.58), S Vert-Co distance(OR=2.53, 95%CI=1.128-5.67) and Sn-G Vert distance(OR=4.67, 95%CI=1.14-19.09) were independent influencing factors for the efficacy of ARS(P<0.05). CONCLUSIONS: The degree of chin deviation, S Vert-Co distance and Sn-G Vert distance in the initial stage of treatment are key indicators for the efficacy of ARS in the treatment of ADDWR. In clinical practice, these indicators can be combined to evaluate the prognosis and optimize the treatment plan.

Key words: Anterior disc displacement with reduction, Anterior repositioning splint, Reduction effect, Chin deviation, Influencing factors

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