再定位垫治疗颞下颌关节盘可复性移位伴间断性 锁结患者的临床观察

目的 观察再定位垫治疗颞下颌关节盘可复性移位伴间断锁结患者的临床疗效。方法 选取2017年12月至2018年6月大连市口腔医院颞下颌关节门诊接诊的34例患者（男9例，女25例，平均年龄31岁），经MRI确诊为颞下颌关节盘可复性移位伴间断性锁结，采用再定位垫治疗，治疗期限为6个月，治疗后1个月和3个月进行随访，比较戴用再定位垫3个月、6个月，取下垫后1个月和3个月复查时的关节弹响，疼痛程度、颞下颌关节功能障碍指数和紊乱指数。结果 治疗结束时，34例患者中32例（94.12%）弹响完全消失，1个月复查时，弹响消失患者占88.24%，3个月复查时，弹响消失患者占76.46%；治疗开始后3个月患者疼痛主诉与治疗前相比有明显下降；颞下颌关节功能障碍指数、肌肉压痛指数和颞下颌关节功能紊乱指数均有显著下降。结论 再定位垫治疗关节盘移位伴间断性锁结，在短期内可有效消除关节弹响，缓解疼痛症状，解除功能障碍，利于关节盘获得良好的盘突关节。

Clinical effects of anterior repositioning splint on temporomandibular joint disc displacement with reduction with intermittent locking

Objective The aim of this study was to analyze the effects of anterior repositioning splint on temporomandibular joint disc displacement with reduction with intermittent locking. Methods 34 patients (9 males and 25 females with an average age of 31 years) with disc displacement with reduction with intermittent locking treated in Dalian Stomatological Hospital from December 2017 to June 2018 were included. All of these patients wore anterior repositioning splints for 6 months and participated in a follow-up observation at 1 month and 3 months after treatment. And then the therapeutic effects including joint noise or pain, the temporomandibular joint dysfunction/disorder index were evaluated. Results At the end of treatment, the joint noise of 32 cases completely disappeared, which accounted for 94.12%. At 1 month after treatment, the joint noise of 88.24% of the patients disappeared, and at 3 months after treatment, it became 76.46%. After 3 months of treatment, the pain level (VAS) decreased significantly compared with that before treatment. Fricton''s TMJ disfunction index, palpation index and craniomandibular index decreased significantly compared with that before treatment. Conclusions Anterior repositioning splint can effectively eliminate joint noise, relieve pain and dysfunction, and promote the articular disc to obtain a good discoid joint, which can be used as an effective way to treat patients with disc displacement with reduction with intermittent locking.