尖牙再定位咬合板治疗颞下颌关节病的临床研究

目的 研究TMJ弹响和疼痛的治疗方法。方法 尖牙再定位咬合板治疗TMJ弹响和疼痛78例。结果 弹响消失者75例（96.2%）,减轻者3例（3.8% );疼痛消失者33/35（94.3%）,减轻者2/35（5.7%）。结论 尖牙再定位咬合板是治疗下颌前伸至前牙对刃状态下弹响能消失（减弱）的TMJ关节盘可复性前移的有效方法。     

再定位咬合板对颞下颌关节紊乱病的临床治疗体会

颞下颌关节紊乱病(temporomandibular disor ders,TMD)是指诸多原因导致的颞下颌关节及周围咀嚼肌群出现的结构、功能及器质性改变。其发病率较高,约25%～88%。患者主要表现为咀嚼肌及关节区肌肉疼痛、开闭口关节弹响及下颌运动障碍等。严重者可伴有头疼、耳疼、眩晕及听力障碍。本科自2002年2月以来应用再定位咬合板治疗此类患者35例,取得满意疗效,现报告如下。     

微型咬合板治疗颞下颌关节紊乱病的临床研究

采用微型咬合板治疗颞下颌关节紊乱病（ＴＭＤ）８８例,男２５例,女６３例,年龄１４～４８岁,平均２７．５岁．结果：症状完全消失４０例（４５．５％）,症状改善４５例（５１．１％）,症状无变化３例（３．４％）．结果表明微型咬合板是治疗ＴＭＤ的一种简便而有较好疗效的保守疗法     

上颌咬合板治疗颞下颌关节紊乱病

为寻找治疗颞下颌关节紊乱病的有效方法。方法 对３４例颞下颌关节紊乱病伴前牙深覆 Ｈｅ患者给予上颌Ｈｅ板治疗。结果 上颌咬合板对颞下凳关节疼痛，弹响以及张口受限等临床症状有明显缓解作用。结论上颌咬合板可作为治疗颞下颌关节乱紊乱病的方法之一。     

再定位咬合板治疗颞下颌关节盘可复性前移位疗效观察

目的评价再定位咬合板治疗颞下颌关节盘可复性前移位的临床疗效。方法选择28名颞下颌关节盘可复性前移位患者。患者戴用再定位咬合板治疗后3个月、6个月、1年、2年复诊,行关节常规检查并拍x线片,评价治疗效果。结果经过再定位咬合板治疗,18名弹响患者中13名（72．22％）弹响完全消失,10名疼痛患者中8名（80．00％）疼痛消失,14名下颌运动异常患者中10名（71．43％）转为正常。26名患者认为治疗有效（92．86％）。结论再定位咬合板对治疗颞下颌关节盘前移位具有较好的疗效。     

2种咬合板治疗颞下颌关节紊乱病的临床疗效分析

目的：研究松弛型咬合板和稳定型咬合板治疗颞下颌关节紊乱病(TMD)的疗效。方法：选择以口颌面部疼痛为主诉的TMD患者68例(急性30例,慢性38例),每组分别戴用松弛型咬合板和稳定型咬合板,比较分析治疗前、后颞肌前束(TA)、咬肌(MM)肌电值及关节疼痛强度的变化。采用SPSS 11.0 软件包对数据进行方差分析和t检验。结果：①静息状态下,2种咬合板治疗后,患者双侧TA及MM肌电电位均较治疗前显著下降(P<0.05)。②紧咬状态下,松弛型咬合板治疗的急性组患者双侧TA及MM肌电电位均较治疗前显著上升,而慢性组患者仅双侧MM肌电电位较治疗前显著上升(P<0.05);稳定型咬合板治疗组患者双侧TA肌电电位治疗前后无显著差异,仅双侧MM肌电电位较治疗前显著上升。③2种咬合板治疗后,患者疼痛指数均较治疗前显著下降;但松弛型咬合板治疗后,在功能状态下,急性组患者疼痛缓解的程度更显著。结论：松弛型和稳定型咬合板均对咀嚼肌有松弛作用,能缓解TMD疼痛,但松弛型咬合板治疗急性TMD患者的疗效更加显著。     

枢轴咬合板治疗颞下颌关节紊乱综合征的临床观察

采用以枢轴咬合板为主要方法治疗颞下颌关节紊乱综合征患者５０例，其中关节盘不可复性前移位３０例，部分可复性前移位１２例，髁突上移位８例。对治疗前后的张口度和关节间隙进行了测量分析，按照国际已有的标准判断疗效，结果表明枢轴咬合板对向下调整髁突位置有明显效果。５０例中，治愈３６例（７２％），好转１４例（２８％）。经３年随访观察，原有的症状无复发。作者认为，枢轴咬合板是治疗上述３种原因所致颞下颌关节紊乱综合征的有效方法     

上颌咬合板治疗颞下颌关节紊乱病

目的为寻找治疗颞下颌关节紊乱病的有效方法。方法对34例颞下颌关节紊乱病伴前牙深覆患者给予上颌板治疗。结果上颌咬合板对颞下颌关节疼痛、弹响以及张口受限等临床症状有明显的缓解作用。结论上颌咬合板可作为治疗颞下颌关节紊乱病的方法之一。     

不同咬合板治疗颞下颌关节紊乱病对患者上气道影响的CBCT研究

目的:分析稳定性咬合板(stabilization splint,SS)及前导性再定位咬合板(anterior repositioning splint,ARS)治疗前后颞下颌关节紊乱病(temporomandibular disorders,TMDs)患者上气道变化.方法:选择56例厦门医学院附属口腔医院就诊的双侧髁...     

稳定咬合板短期治疗颞下颌关节紊乱病的临床疗效观察

颞下颌关节紊乱病（temporomandibular disorders，TMD）足口颌系统的常见病和多发病，临床上主要表现为颢下颌关节区疼痛、异常关节音、下颌运动功能障碍等三大症状。由于其病因复杂，目前尚缺少有效的治疗方法。稳定咬合板作为一种保守、可逆、无创性的治疗方法被广泛的应用在TMD的治疗上，但是，对于稳定咬合板的疗效尚有争议。本试验采用随机、对照的试验方法，用客观、统一、定量的标准Fricton指数评估稳定咬合板短期治疗TMD的临床疗效，结果显示，稳定咬合板短期内可有效缓解TMD患者肌肉和关市的疼痛。     

稳定性咬合板治疗颞下颌关节紊乱病的咀嚼肌肌电图研究

目的：通过对颞下颌关节紊乱病（Temporomandibular disorders,TMD）患者进行稳定性咬合板的可逆性咬合治疗,然后利用肌电图仪测量治疗前后患者的咀嚼肌（TA和MM）的肌电情况,分析探讨用稳定性咬合板对颞下颌关节紊乱病患者咀嚼肌肌电图的影响。方法：选取来我院就诊的10例咀嚼肌功能紊乱患者,在稳定性咬合板治疗前和治疗后3个月时,分别用肌电图仪对其咀嚼肌（TA和MM）进行肌电检查,并通过比较治疗前后的咀嚼肌活动不对称指数情况。结果：戴入稳定性咬合板3个月后,颞肌前束与咬肌的MPP和ICP高电位降低（P〈0.05）;最大紧咬时双侧咀嚼肌总体不对称性指数（Astot）、双侧颞肌不对称性指数（ASTA）和双侧咬肌不对称性指数（ASMM）均降低（P〈0.05）。结论：颞下颌关节紊乱病患者通过稳定性咬合板进行咬合治疗后,使患者双侧咀嚼肌的MPP和ICP高电位较治疗前有明显的降低,最大紧咬时双侧咀嚼肌活动不对称性得到明显的改善。     

ҧ�ϰ���������ؽ����Ҳ���״

提要：颞下颌关节紊乱病（TMD）是口腔临床常见病之一,其治疗方法众多。咬合板作为一种保守、可逆的治疗方法被广泛应用在TMD的治疗上。然而,各类咬合板治疗TMD的疗效尚不完全明确,本文结合近年来国内外文献对其进行综述。     

稳定型咬合板治疗颞下颌关节紊乱病疼痛症状的研究

目的：探讨稳定型咬合板治疗颞下颌关节紊乱病（TMD）疼痛的疗效。方法：TMD疼痛患者61例，急性组28例（男11例，女17例）；慢性组33例（男18例，女15例）。记录治疗前后疼痛指数，双侧颞肌前束（temporal anterior，TA）和咬肌（masseter muscle，MM）牙尖交错位最大紧咬时电位及最大紧咬时咬合接触情况。结果：（1）2组治疗后1月疼痛指数均明显低于治疗前（P〈0．05），治疗前后疼痛强度差值及显效率2组之间无显著差异（P〉0．05）。（2）治疗后无论是急性组还是慢性组TA及MM最大紧咬电位症状侧均较治疗前明显升高（P〈0．05），而非症状侧治疗前后无明显差异（P〉0．05）。（3）治疗后急性组TA和MM肌电不对称指数与治疗前相比均明显降低（P〈0．05）。治疗后肌电不对称指数TA慢性组明显高于急性组（P〈0．05），而MM无明显差异（P〉0．05）。（4）2组治疗前后左、右两侧咬合接触点数、以及咬合接触不对称指数无明显差异（P〉0．05）。结论：稳定型咬合板治疗可以明显缓解TMD疼痛，但对急、慢性疼痛的缓解程度无明显差异。其机制可能与肌功能活动情况易于得到明显改善等生理学基础有关。     

Efficacy of stabilisation splint treatment on temporomandibular disorders

Summary The evidence supporting the use of stabilisation splints in the treatment of temporomandibular disorders (TMD) is scarce and a need for well‐controlled studies exists. The aim of this randomised, controlled trial study was to assess the efficacy of stabilisation splint treatment on TMD. The sample consisted of 80 consecutive referred patients who were randomly assigned to the splint group (n = 39) and the control group (n = 41). Subjects in the splint group were treated with a stabilisation splint, whereas subjects in the control group did not receive any treatment except counselling and instructions for masticatory muscle exercises which were given also to the subjects in the splint group. Outcomes were visual analogue scale (VAS) on facial pain intensity and clinical findings for TMD which were measured at baseline and after 1‐month follow‐up. The differences in change between the groups were analysed using regression models. Facial pain decreased and most of the clinical TMD findings resolved in both of the groups. The differences in changes in VAS or clinical TMD findings between the groups were not statistically significant. The findings of this study did not show that stabilisation splint treatment in combination with counselling and masticatory muscle exercises has additional benefit in relieving facial pain and increasing the mobility of the mandible than counselling and masticatory muscle exercises alone in a short time‐interval.     

Evaluation of the efficacy of different treatment modalities for painful temporomandibular disorders

The purpose of this study was to clinically evaluate the efficacies of three treatment methods and to compare their outcomes in patients with painful disc displacement. The study group comprised 45 patients with unilateral temporomandibular disorders who fell into Axis I group II (with limited mouth opening) of the Research Diagnostic Criteria for Temporomandibular Disorders. Magnetic resonance imaging was used for definitive diagnosis. The patients were divided randomly into three groups according to the treatment method: splint therapy, splint therapy with ultrasound-guided arthrocentesis, and splint therapy with low-level laser therapy. Patients were followed up after treatment for 6 months. The groups were compared in terms of pain and functional jaw movements (unassisted mouth opening without pain, maximum unassisted mouth opening, and contralateral movements). At the end of treatment, functional jaw movements were significantly increased while pain values were significantly decreased in all groups (P < 0.05). Group 2 had a quicker improvement in terms of mouth opening scores at the end of the first month, and unassisted mouth opening without pain was found to be more than 35 millimetres in all groups at the end of 6 months. All treatment modalities showed effective results on pain and functional jaw movements in the treatment of temporomandibular disorders.     

稳定性牙合板治疗颞下颌关节紊乱病患者后髁突骨密度变化的CBCT研究

目的 利用CBCT测量颞下颌关节紊乱病(TMD)患者稳定性牙合板治疗前后髁突骨密度变化,分析稳定性牙合板对髁突改建的影响.方法 纳入40例稳定性牙合板治疗的TMD患者,治疗前后拍摄CBCT.运用MIMICS 21.0软件中Density功能测量髁突皮质骨密度,对髁突前斜面、顶部、后斜面骨密度进行统计学分析.结果 治疗前...     

Correlation of splint therapy outcome with the electromyography of masticatory muscles in temporomandibular disorder with myofascial pain

Abstract

Objectives. The aim of this study was to assess the effect of occlusal splint therapy on the electromyographic amplitude records (μV) of masticatory muscles in temporomandibular disorder (TMD) with myofascial pain and to detect a possible existence of a relationship between this effect and the treatment outcome. Materials and methods. Forty patients (23 females and 17 males) having TMD with myofascial pain were included in this study. They were randomly divided into two equal groups (20 of each). The first group (A) was treated by occlusal splints for 6 months while the second group (B) acted as a control. A clinical assessment and surface electromyography (EMG) for the masticatory muscles were performed at the beginning of the study, then 6 months later. The collected data were statistically analyzed using paired t-test. The differences were considered significant at p < 0.05. Results. The results showed that 85% of group A either completely recovered (35%) or clinically improved (50%) while only 20% of group B had a spontaneous improvement. In group A, the means of the electromyographic amplitude records (μV) of the monitored muscles have decreased after 6 months. However, the decrease was statistically insignificant (p > 0.05) in the patients (15%) who had no clinical changes. In group B, the means of the muscles' records (μV) in the left side slightly increased while those of the right side slightly decreased. These changes were statistically insignificant (p > 0.05). Conclusions. Occlusal splint could eliminate or improve the signs and symptoms of TMD patients with myofascial pain. It reduces the electromyographic amplitude records (μV) of the masticatory muscles. The splint therapy outcome has a correlation with the electromyographic amplitude changes of the masticatory muscles.     

咬合板对颞下颌关节紊乱病相关颌面部疼痛的影响

颞下颌关节紊乱病（temporomandibular disorders, TMD）是口颌面部慢性痛的主要来源,严重干扰日常活动。咬合板是颞下颌关节紊乱病的最常用的治疗方法之一,但其疗效尚未完全明了。学者们多年来致力于对咬合板的作用机制、疗效的研究,但至今尚未得出统一的结果。该文将对咬合板的作用机制、咬合板的分类、TMD相关疼痛的种类与咬合板的选择、TMD的其他保守治疗与咬合板的关系四个方面对于咬合板治疗颞下颌关节紊乱病相关颌面部疼痛的疗效进行进行综述。     

红外偏振光治疗各类颞下颌关节紊乱病的疗效分析

目的:探讨红外偏振光对不同类型颞下颌关节紊乱病的临床疗效,为临床正确选择这种理疗技术的适应证提供依据。方法:对426例颞下颌关节紊乱病患者(657侧关节)进行了红外偏振光理疗。结果:发现红外偏振光理疗对各类型颞下颌关节紊乱病引起的关节或肌肉区的疼痛症状有明显的疗效;对咀嚼肌紊乱疾病类引起的肌肉区疼痛的疗效(94%)高于对有关节结构紊乱疾病类引起的关节疼痛症状为主的疗效(72%);对非绞锁关节张口度的改善具有良好的疗效;经治疗后,在疼痛明显减轻的同时,关节弹响的发生率反而提高;对关节结构紊乱疾病类引起的下颌绞锁运动没有显著疗效,绞锁关节张口度在治疗前后没有显著性差异;近期观察关节内骨关节病类改变没有明显差异。结论:红外偏振光理疗对各类型颞下颌关节紊乱病引起的关节或肌肉区的疼痛症状有良好的疗效,并可以改善张口度。对可能由关节结构紊乱引起的弹响及下颌绞锁运动没有明显疗效,在有下颌绞锁运动的情况下,对张口度的改善亦不明显,对关节内骨关节病类改变没有明显近期疗效。     

正畸治疗与颞下颌关节症状的相关研究

目的：探讨正畸治疗和颞下颌关节紊乱病（TMD）的关系。方法：设计正畸组、错[牙合]组和正常组的调查表,用Visual Foxpro6．0建立相应的数据库,对173例已正畸治疗者、95例有错[牙合]畸形但未治疗者和32例正常对照进行TMD症状、体征及相关情况的问卷调查和专科检查,所得结果用基于Helkimo指数改良设计的数据库进行分析,采用SPSS10．0软件包进行成组设计两样本比较的秩和检验。结果：正畸组和错[牙合]组在主诉症状指数、临床症状指数和咬合指数的分布上存在显著差异（P〈0．001）;正畸组和正常组在主诉症状指数和临床症状指数的分布上有显著差异（P〈0．001）,但在咬合指数的分布上无显著性差异（P〉0．05）。结论：正畸治疗后患者在一定时期内易出现颞下颌关节紊乱病的症状和体征。