前牙(牙合)垫治疗颞下颌关节紊乱病伴深覆(牙合)的临床观察

目的：前牙[牙合]垫治疗颞下颌关节紊乱病伴深覆[牙合]的临床效果。方法：对59例颞下颌关节紊乱伴深覆牙争患者进行前牙[牙合]垫治疗。结果：59例中58例接受随访．55例症状明显改善。结论：前牙[牙合]垫可有效改善颞下颌关节紊乱症状。     

软牙合垫联合物理疗法治疗颞下颌关节紊乱症的疗效观察

目的观察软牙合垫联合物理疗法治疗颞下颌关节紊乱症（TMD）的疗效。 方法选取TMD患者150例,按照随机数字表法将其分为综合治疗组和局部封闭组,每组75例。综合治疗组采用软牙合垫联合物理疗法（局部超短波、局部半导体激光照射）治疗,局部封闭组行痛点封闭。治疗前及治疗3个月后,采用张口度测量、过筛法、Fricton指数对2组患者的张口度、咀嚼效能、总有效率进行评定。 结果治疗前,2组患者张口度、咀嚼效能比较,差异无统计学意义（P>0.05）。与组内治疗前比较,综合治疗组患者治疗3个月后张口度［（2.82±0.15）cm］、咀嚼效能［（94.6±4.1）%］显著改善（P<0.05）。与局部封闭组治疗3个月后比较,综合治疗组治疗3个月后张口度、咀嚼效能较为优异,差异有统计学意义（P<0.05）。治疗3个月后,综合治疗组总有效率（93.34%）明显高于局部封闭组总有效率（70.67%）。 结论软牙合垫联合物理疗法可有效治疗TMD,提高其张口度及咀嚼效能,值得临床应用、推广。     

颞下颌关节疾病患者合垫治疗的护理

【】目的：探讨颞下颌关节紊乱病治疗的整体护理对策, 总结相关护理体会。方法：回顾性总结2009 年9月至2013 年10 月期间我院收治的427例合垫治疗颞下颌关节紊乱病患者的护理工作及相关要点。结果：将合垫治疗后恢复正常盘髁关系者定为治疗成功,反之则为失败。结果显示,427 例患者414例治疗成功; 8例治疗失败,关节盘移位没有改善或盘移位进一步恶化;5例患者中途放弃治疗。总的有效率达到96.96%。结论：护理工作是整个医疗的保障,良好的护理能充分调动患者的主观能动性,创造利于治疗和康复的最佳身心状态;也可使患者得到高质量、高水平且安全舒适的服务与治疗。     

不同方式治疗颞下颌关节紊乱综合征的效果观察

目的 探讨不同方式治疗颞下颌关节紊乱综合征的效果。方法 选取2019年7月至2022年3月洛阳市第三人民医院收治的99例颞下颌关节紊乱综合征患者为研究对象,根据治疗方式分为两组。其中研究组40例,采用稳定型牙合垫和手法治疗;对照组59例,单纯采用稳定型牙合垫治疗。比较两组患者的临床疗效,治疗前后的下颌功能损害程度,治疗前后视觉模拟评分法(VAS)评分及最大张口度的差异,比较两组治疗后的预后情况。结果 研究组的总有效率(39/40,97.5%)显著高于对照组(50/59,84.7%)(P<0.05)。治疗前,两组的MFIQ评分比较,差异未见统计学意义(P>0.05),而治疗后两组的下颌功能障碍问卷评分均较治疗前降低,且研究组更低(P<0.05)。治疗前,两组的VAS评分及最大张口度比较,差异未见统计学意义(P>0.05)。治疗后,两组的VAS评分及最大张口度均较治疗前有所改善,且研究组改善更明显(P<0.05)。两组治疗后口腔健康影响程度量表中功能限制、社交障碍、心理不适、生理性疼痛、生理障碍、心理障碍、残障评分和总分均明显降低,且研究组更低(P<0....     

激光治疗颞下颌关节紊乱症

颞下颌关节紊乱症（TMJID）指领下颌关节（TMJ）在行使功能运动过程中出现疼痛、杂音和下颌运动障碍等症状的症候群。本病多属功能紊乱和结构改变,晚期多为品质性破坏[1]。目前采用保守治疗为主。为寻求一种新的行之有效的治疗方法,我们采用激光治疗仪治疗172例TMJID患者,结果如下。1资料与方法1．1一般资料随机收集1990年3月～1999年10月我科门诊就诊的TMJID患者172例,男88例,女84例;年龄20～41岁,平均30岁;TMJID类型为翼外肌功能亢进34例占19．8％,翼外肌痉挛78例占】53％,关节盘后区损伤40例占23．3％,关节囊和关节…     

微波治疗颞下颌关节紊乱病疗效分析

目的:观察微波治疗颞下颌关节紊乱痛的临床疗效.方法:将67例颞下颌关节紊乱病患者随机分为2组,治疗组(40例)应用微波治疗,对照组(27例)应用中药局部湿热敷治疗,于治疗后3,6,12个月随访观察其疗效.结果:治疗组有效率分别达87.50%,84.21%,77.14%,疗效优于对照组(55.56%,40.00%,34.78%)(P<0.01).结论:微波治疗颞下颌关节紊乱病疗效明显.     

内窥镜手术治疗颞下颌关节紊乱病的临床研究

目的评价关节内窥镜手术治疗颞下颌关节紊乱病的临床效果.方法应用关节内窥镜通过镜下各种微型手术器械,内窥镜直视下手术,通过灌洗、粘连松解、清扫等方法去除关节腔内各种病变和关节盘复位术,治疗113例(132侧关节)颞下颌关节紊乱病.结果随访6～84个月,随访期内,张口度增加0～16mm,平均9.6mm(P＜0.001),健侧侧向运动度增加2.5～7.8mm,平均4.8mm(P＜0.01);术后91.4%的患者疼痛缓解,疼痛缓解程度1.5～5.0,平均3.6(P＜0.001).62.5%的患者弹响消失.总的疗效评定为优良50例(44.2%),改善52例(46.0%),无效11例(9.7%),总有效率为90.3%(102/113).术后无严重并发症发生.结论内窥镜手术治疗颞下颌关节紊乱病是一种有效的方法.     

颞下颌关节紊乱指数临床应用评价

选取2012年4月-2013年4月期间我院收治的77例TMD患者,根据评价方法的不同分为Helkimo组和Fricton组,分别Helkimo利用临床检查功能障碍指数和Fricton颞下颌关节紊乱指数定量计算每位患者的颞下颌关节紊乱指数,比较两种方法的应用效果。结果不同医师同种方法评价两组患者的指数得分差异无显著性（P〉0.05）;Fricton组评价结果的一致性优于Helkimo组,差异具有显著性（P〈0.05）。见表2。结论 Fricton指数是一种方便、有效、客观定量的指标,适用于TMD功能障碍程度的评价,具有一定的临床适用价值。     

弱激光治疗颞下颌关节紊乱病的疗效观察

目的探讨弱激光治疗颞下颌关节紊乱病的临床应用和效果。方法对198例颞下颌关节紊乱病的患者进行弱激光局部照射,分析治疗效果。结果弱激光对各类型颞下颌关节紊乱病所致的关节或肌肉区疼痛皆有疗效。经1～3个疗程治疗,痊愈123例,有效31例,好转25例,无效19例,显效率为77.8%。咀嚼肌功能紊乱型(Ⅰ型)的显效率(91.5%)高于关节结构紊乱型(Ⅱ型)(75.0%)和关节器质性改变型(15.0%)(P均<0.05)。结论弱激光是一种简单有效、经济实用的治疗颞下颌关节紊乱病的方法。     

超短波治疗颞下颌关节紊乱征的效果评价

颞下颌关节紊乱征累及颞下颌关节和(或)咀嚼肌系统，临床表现为疼痛、弹响、开口受限等。采用Fricton颞下颌关节紊乱指数评价80例颞下颌关节紊乱征患者应用超短波物理治疗效果。     

Management of disorder of temporomandibular joint syndrome using elastic resin occlusal pad: a clinical observation

Disorderoftemporomandibularjointsyndromeiscommoninclinic．Patientssufferedalotfromit犤１犦．Now,researchersareseekingoptimaltreatmentmethods,butnosatisfyingprojectaredeveloped．Inrecentyears,wetreated２５pateintssufferedfromdisorderoftemporomandibularjointsyndromeusingocclusalpadofelasticresin,theeffectwassatisfying．１Subjectandmethods１．１Subject２５patientswithdisorderoftemporomandibularjointsyndromewererecruitedfromoutpatientsdepartmentoforalsurgery,including１４males,１１females（…     

延续性护理对颞下颌关节紊乱病患者健康管理依从性及知识知晓程度的效果

目的 观察延续性护理对颞下颌关节紊乱病患者健康管理依从性及知识知晓程度的效果。方法 选择2021年1月至2022年12月就治于南京医科大学附属口腔医院的颞下颌关节紊乱病患者100例为观察样本,2021年1月至12月的50例患者设为对照组,2022年1月至12月的50例患者设为观察组。遵循颞下颌关节紊乱病咬合板治疗,给予对照组患者常规护理;于此基础之上给予观察组患者延续性护理。对干预后的两组患者各项观察指标进行比较。结果 观察组患者疾病不确定感评分低于对照组,健康管理知识知晓度评分、健康管理依从性评分高于对照组,疼痛评分低于对照组,张口度高于对照组（P＜0.05）。结论 对于颞下颌关节紊乱病患者给予延续性护理,有利于其疾病不确定感的减低、健康管理知识知晓度与依从性的提升、疼痛度的减低与张口度的增大。     

线性测量颞下领关节在咬合重建中的可适位

背景：牙合面形态的改变影响咀嚼肌的收缩、咬合力的大小与方向,进而影响包括颞下颌关节在内的整个口颌系统的受力环境,是颞下颌关节生理性和病理性改建的最主要的刺激因素.目的：测量分析髁状突在咬合重建中的可适位.方法：对24例牙列重度磨耗伴颞下颌关节紊乱患者采用固定修复方法进行咬合重建治疗,疗程9个月,治疗前后拍摄正中牙合位颞下颌关节CT片利用计算机技术进行线性测量,分析关节间隙的变化.结果与结论：咬合重建修复治疗后髁突在关节窝内相对参考位置,左侧由-（16.96±2.01）%增至＋（14.20±1.24）%;右侧为-（10.64±1.50）%增至（11.51±3.00）%.治疗前的咀嚼效率约为治疗后的62.15%-89.09%,平均为74.88%,差异有显著性意义（P 〈0.05）.24例咬合重建后的患者髁状突在关节窝中均向前下移位至关节结节前1/3与关节结节顶点下方之间.提示咬合重建后髁状突向前下移位至关节结节前1/3与关节结节顶点下方之间的可适位改建取得了良好的临床治疗效果,髁状突位于关节窝中央并非惟一的生理位置.     

Sleep continuity and architecture: Associations with pain‐inhibitory processes in patients with temporomandibular joint disorder

Recent research suggests bi‐directional interactions between the experience of pain and the process of sleep; pain interferes with the ability to obtain sleep, and disrupted sleep contributes to enhanced pain perception. Our group recently reported, in a controlled experimental study, that sleep fragmentation among healthy adults resulted in subsequent decrements in endogenous pain inhibition. The present report follows up that observation by extending this line of research to a sample of patients experiencing persistent pain. Patients with chronic temporomandibular joint disorder (TMD) pain were studied using polysomnography and psychophysical evaluation of pain responses. We assessed whether individual differences in sleep continuity and/or architecture were related to diffuse noxious inhibitory controls (DNIC), a measure of central nervous system pain inhibition. Among 53 TMD patients, higher sleep efficiency and longer total sleep time were positively associated with better functioning of DNIC (r = 0.42–0.44, p < 0.01; ps < 0.05 for the multivariate analyses). These results suggest the possibility that disrupted sleep may serve as a risk factor for inadequate pain‐inhibitory processing and hint that aggressive efforts to treat sleep disturbance early in the course of a pain condition might be beneficial in reducing the severity or impact of clinical pain.     

Immediate and short-term effects of phototherapy on pain,muscle activity,and joint mobility in women with temporomandibular disorder: a randomized,double-blind,placebo-controlled,clinical trial

Objectives: The aim of the present study was to evaluate the immediate and short-term effects of phototherapy on pain intensity, the pressure pain threshold (PPT), maximum vertical mandibular movement, and the electrical activity of the masseter and temporal muscles in women with temporomandibular disorder (TMD).

Methods: Sixty women were randomly allocated to four different groups and submitted to phototherapy with a combination of super-pulsed laser (905?nm), red (640?nm), and infrared (875?nm) light emitting diodes in the same equipment on the masseter (three points) and temporal (two points) muscles bilaterally in a single session. The following doses were used in each point of application: Group 1 – 2.62 J; Group 2 – 5.24 J; Group 3 – 7.86 J; placebo group. Pain intensity was determined using the visual analog scale. The PPT was analyzed using a digital algometer. Vertical mandibular movement was measured using digital calipers. Myoelectrical activity of the masseter and temporal muscles was measured using electromyography. Four evaluations were performed: pre-intervention, immediately after, 24 and 48?hours after phototherapy.

Outcomes: A significant reduction in pain intensity during the post-treatment evaluations in comparison to the pretreatment evaluation was observed in group 1 (Median difference?=?2.60 [95% CI?=?1.35–3.85]) and group 2 (Median difference?=?2.2 [95% CI?=?0.98–3.42]) especially after 48?hours and group 3 (Median difference?=?2.50 [95% CI: 0.56–4.46]) especially after 24?hours, with a moderate effect size, but no effect was found regarding the other variables.

Conclusions: A single session of combined phototherapy was capable of reducing pain intensity in individuals patients with TMD.

ClinicalTrials.gov (NCT02018770).

• Implications for Rehabilitation

• Phototherapy device combining two light sources (LED and laser), and different densities in the same device is a novelty in the rehabilitation market, and has proved to be a useful intervention for people with temporomandibular disorders.

• This mode of phototherapy is another option that assists in the rapid intervention in pain symptoms, promoting a considerable degree of comfort to the patient moments after its application.

     

Evaluation of integral electromyographic values and median power frequency values in women with myogenous temporomandibular disorder and asymptomatic controls

Background

Surface electromyography (EMG) has been used as a reliable tool for the evaluation of electrical muscle activity.

Treatment of condylar osteophyte in temporomandibular joint osteoarthritis with muscle balance occlusal splint and long-term follow-up: A case report

BACKGROUNDCondylar osteophytes, a remodeling form of temporomandibular joint osteoarthritis (TMJ OA), mainly manifest as marginal angular outgrowths of the condyle. Previous researchers have advocated surgical removal of condylar osteophytes. Reports on the effect of occlusal splint on TMJ OA patients’ joints have mostly focused on treatment with this splint, which can reduce the absorption of the affected condyle and promote repair and regeneration. However, the effect of the splint on the dissolution of condylar osteophytes has not yet been reported.CASE SUMMARYA 68-year-old female patient suffered from occlusal discomfort with left facial pain for 2 years. Cone beam computed tomography showed a rare osteophyte on top of her left condyle. She was finally diagnosed with TMJ OA. The patient refused surgical treatment and received conservative treatment with a muscle balance occlusal splint. The pain experienced by the patient on the left side of her face was relieved, and her chewing ability recovered after treatment. The osteophyte dissolved, and the condylar cortex remained stable during long-term follow-up observations.CONCLUSIONThe muscle balance occlusal splint could be a noninvasive means of treating condylar osteophytes in TMJ OA patients.     

Immediate effects of rhythmic joint mobilization of the temporomandibular joint on pain,mouth opening and electromyographic activity in patients with temporomandibular disorders

BackgroundRhythmic joint mobilizations (RJM) of the temporomandibular joint (TMJ) are employed to relieve pain and improve function in patients with temporomandibular disorders (TMD). However, the evidence on the immediate effects of RJM in patients with TMD is scarce. The aim of this study was to assess the immediate clinical and functional effects of RJM in patients with TMD.Materials and methodsThis was a one-group quasi-experimental before and after study. Thirty-eight patients with TMD were assessed by means of pain intensity (visual analogue score, VAS), pressure pain threshold (PPT, measured through pressure algometry on the masseter and temporal muscles), mouth opening (MO, measured with a ruler), and surface electromyographic activity of the masseter and temporal muscles (asymmetry index, AI). Measurements were performed before and after a single, 1-min session of RJM of each TMJ. All statistical analyses were performed using the SPSS version 20.0 statistical package.ResultsA statistical significant difference was found in pain intensity, PPT and MO after the intervention (p < 0.05). No difference was found in the AI. A large effect size was observed for pain intensity, PPT of the left and right masseter muscles and MO (d = 0.85–1.13), whereas for the left and right temporal muscles the effect size was moderate (d = 0.62) and small, respectively (d = 0.49).ConclusionIn this sample of patients with TMD, a single session of RJM of the TMJ seemed to be effective in reducing pain intensity, increasing PPT and improving MO immediately after the intervention, without differences in the AI.     

关节松动术配合理疗治疗颞下颌关节紊乱综合征的疗效评估

目的:观察关节松动术手法配合理疗治疗颞下颌关节紊乱综合征(TMD)的疗效。方法:筛选TMDⅡb类患者40例,随机分为关节松动术配合理疗组(A组,n=20)、针灸配合理疗组(B组,n=20)。治疗前及治疗4周后采用疼痛视觉模拟评分(Visual Analogue Scale,VAS)、最大张口度、下颌功能障碍问卷(Mandibular Function Impairment Questionnaire,MFIQ)、MRI评定患者的疼痛程度、最大张口度、下颌功能及盘髁活动度。结果:治疗后,两组疼痛(A组1.10±1.59,B组1.25±1.37)较治疗前差异均具有显著性意义(P0.001),两组组间比较差异无显著性意义(P0.05);A、B组最大张口度(A组36.50±4.68mm,B组26.15±4.49mm)、下颌功能障碍(A组0.50±0.76,B组0.75±0.55)、盘髁活动度(A组6.54±1.22mm,B组4.43±1.36mm)较治疗前差异均具有显著性意义(P0.001),两组组间比较差异有显著性意义(P0.05)。结论:关节松动术配合理疗的治疗方法可有效改善TMDⅡb类患者的关节疼痛。与针灸配合理疗治疗相比较,关节松动术配合理疗对张口受限、下颌功能障碍、盘髁活动度等症状的改善更加明显。