全可调(牙合)架与平均值(牙合)架再定位咬合板治疗颞下颌关节可复性盘前移位临床比较研究

摘要

Objective To compare the efficacy of repositioning splint therapy made with average values articulator and full-adjustable articulator for anterior discdisplacement.Methods Totally 46 patients were with anterior disc displacement with reduction.They went to TMD Department of Dalian Stomatological Hospital from Jun,2010 to Jun,2016.They were divided into two groups randomly.Group Ⅰ (n=23)used repositioning splint made with average values articulator and group Ⅱ (n=23)used full-adjustable articulator.After wearing splint all patients were examined using clinical temporomandibular joint disorder examination protocol,including muscle palpation and occlusion adjustment.Record the number of the occlusion adjustment.Results All of the patients had no joints clicks in both groups.The pains of 80％ patients disappeared in group Ⅰ and the pains of 95％ patients disappeared in group Ⅱ.The opening degree of all patients was increased in both groups.The average number of the occlusion adjustment was 8±0.73 in group Ⅰ and 4±0.67 in group Ⅱ.Conclusion The repositioning splint made by full-adjustable articulator for anterior disc displacement with reduction is more effective,such as less further consultation and occlusion adjustment,short treatment process and high patient satisfactions.%目的 比较应用全可调(牙合)架与平均值(牙合)架制作的再定位咬合板治疗颞下颌关节可复性盘前移位的疗效.方法 选择2010年6月至2016年6月于大连市口腔医院颞下颌关节病门诊就诊的颞下颌关节可复性盘前移位患者46例,按照随机原则随机分为两组,每组23例,分别应用全可调(牙合)架及平均值(牙合)架制作再定位咬合板.戴用咬合板后按时预约复诊调(牙合),同时检查患者的关节、肌肉症状,记录复诊调(牙合)次数.结果 两组患者在治疗后弹响症状均全部消失.平均值(牙合)架组患者治疗后有16例疼痛症状消失(16/20,占80％),20例开口度有改善(20/20,占100％).全可调(牙合)架组患者治疗后有20例疼痛症状消失(20/21,占95％),18例开口度有改善(18/18,占100％).两组在治疗关节弹响、疼痛和改善开口度方面的差异均无统计学意义(均P＞0.05).平均值(牙合)架组患者平均复诊调(牙合)(8±0.73)次,全可调(牙合)架组患者平均复诊调(牙合)(4±0.67)次,两组在调(牙合)次数上的差异有统计学意义(P＜0.05).结论 使用全可调(牙合)架制作再定位咬合板比使用平均值(牙合)架制作,对于治疗关节盘移位的疗效更加确切,复诊调(牙合)次数少,疗程短,患者满意度较好.