超短波治疗颞下颌关节滑膜炎的临床疗效评价

目的 探讨超短波疗法对颞下颌关节滑膜炎的临床疗效,为临床应用提供依据。方法 选择确诊为颞下颌关节滑膜炎的患者45例,随机分成三组:药物治疗组、超短波治疗组和超短波联合药物治疗组。采用Friction指数对治疗前后进行评分,采用疼痛直观模拟标尺(VAS)对治疗后进行评分并记录相应分值,进行自身及组间比较。结果 三种治疗方法均能够缓解颞下颌关节滑膜炎引起的关节区的疼痛症状,改善张口度。超短波治疗组与超短波联合药物治疗组疗效均优于单纯的药物治疗组,但两组之间未见明显统计学差异。结论 超短波治疗能够明显缓解颞下颌关节滑膜炎引起的关节区的疼痛症状,并可以改善张口度,是一种可靠的临床无创治疗方法。     

半导体激光治疗颞下颌关节紊乱病的疗效探讨

颞下颌关节紊乱病为颞下颌关节疾病中最常见的一种[1],由于其特定的生理解剖与频繁的活动,使其极易产生一系列结构与功能紊乱。临床表现为疼痛、张口异常,关节弹响等,但其病因与发病机制较复杂,故临床治疗方法较多,疗效不一。以往常用的方法为理疗和药物治疗,自2000年始,我科采用半导体激光[2]治疗该病,取得了较为满意的疗效,现总结报告如下。1病例与方法1.1临床资料2000年～2002年,我科门诊治疗颞下颌关节紊乱病患者176例。其中激光治疗组128例,男58例,女70例,年龄23～80岁;红外线治疗组48例,男22例,女26例,年龄25～74岁。患者主诉颞下颌关…     

脉冲半导体激光治疗颞下颌关节疼痛的疗效观察

目的　观察脉冲半导体激光穴位照射对颞下颌关节疼痛的疗效。方法　随机选择门诊非器质性改变 ,以咀嚼肌功能紊乱为主的颞下颌关节疼痛患者 5 6例 ,分为脉冲半导体激光加药物试验组和单纯药物对照组 ,每组 2 8例每例均进行心理支持和康复教育。试验组每日照射 5个穴位 ,每穴 3min ,5d为 1个疗程 ,每日另加萘普生缓释胶囊和安定片与对照组等量服 ,两个疗程结束 ,经 6个月～ 1年随访后进行统计分析。结果　试验组起效快 ,有叠加效应 ,显效率 82 .14 % ;对照组起效慢 ,显效率 35 .71% ;经校正卡方检验 χ2 =12 .4 7,P <0 .0 2 5 ,差别有显著性。结论　脉冲半导体激光穴位照射是治疗颞下颌关节疼痛的高效无创、简便易行的治疗手段之一。长期效果待观察     

颞下颌关节紊乱综合征继发性滑膜炎手术及病理观察

本文包括颞下颌关节紊乱综合征１４例手术病例资料，全部病例均有较长时间的严重关节疼痛史。根据术中观察及术后标本病理观察结果，认为此类病例颞下颌关节滑膜炎是确实存在的；并认为ＴＭＪＤＳ滑膜炎是关节内微小创伤所致的继发性滑膜炎，为ＴＭＪＤＳ关节顽固性疼痛的原因之一。     

镓铝砷半导体激光治疗颞下颌关节紊乱综合征的临床观察

颞下颌关节综合征是口腔颌面部常见疾病之一 ,发病原因复杂 ,治疗比较困难。疼痛是绝大多数患者就诊的原因 ,因此缓解和消除关节疼痛是治疗本征的关键。本文应用镓铝砷半导体激光治疗仪对 30例颞下颌关节功能紊乱综合征患者进行治疗 ,取得满意疗效 ,报道如下。1　材料和方法1 1　病例选择　随机选择门诊疼痛性颞下颌关节紊乱综合征患者 30例 ,Ｘ片显示无明显器质性病变 ,并排除颌面部疾患 ,无系统性疾病。其中男性 11例 ,女性 19例 ,年龄 17～ 6 2岁 ,平均年龄 36 .5岁。1 2　仪器　采用日本森田公司生产的袖珍型镓铝砷半导体激光治疗仪 ,输…     

颞下颌关节紊乱病实验动物模型的研究进展

颞下颌关节紊乱病是口腔颌面部常见病，由于其发病隐匿，加之颞下颌关节的特殊解剖关系，使临床研究比较困难，因此建立实验动物模型研究其发病机制及治疗手段十分必要。本文则就颞下颌关节紊乱病实验动物模型的选择，建立方法及其在病理、免疫、生化、生物力学等方面的研究进展作一综述。     

颞下颌关节色素绒毛结节性滑膜炎

色素绒毛结节性滑膜炎（PVNS）是一种较罕见的影响关节内滑膜层的疾病。1941年．Jaffe等学者首次对PVNS进行全面阐述,认为这是一种病因不明的良性滑膜炎症病变。PVNS累及颞下颌关节（TMJ）的报告极为罕见。本文描述的是1例78岁男性的右侧TMJPVNS。临床检查发现其右耳前肿物：MRI扫描显示其右侧髁突外侧紧邻关节囊的肿物。本文对该病的临床和病理特征进行了阐述。     

低强度激光治疗颞下颌关节紊乱病的疗效评价

目的 评估低强度激光(LLLT)疗颞下颌关节痛的效果.方法 将颞下颌关节痛的患者按随机、双盲原则分为激光组(n=21)和对照组(n=21),每位患者均接受连续6d、每天1次的激光或假激光治疗.在治疗前、治疗后、治疗后1月、治疗后2月14个时点对患者的疼痛程度、功能状态进行测量和评估.结果 2组中疼痛视觉模拟评分(VAS...     

Low intensity laser therapy in the treatment of temporomandibular disorders: a double-blind study

This study aimed to evaluate the effectiveness of low intensity laser therapy (LILT) in 30 patients presenting temporomandibular joint (TMJ) pain and mandibular dysfunction in a random and double-blind research design. The sample, divided into experimental group (1) and placebo group (2), was submitted to the treatment with infrared laser (780 nm, 30 mW, 10 s, 6.3 J/cm(2)) at three TMJ points. The treatment was evaluated throughout six sessions and 15, 30 and 60 days after the end of the therapy, through visual analogue scale (VAS), range of mandibular movements and TMJ pressure pain threshold. The results showed a reduction in VAS (p < 0.001) and through the ANOVA with repeated measures it was observed that the groups did not present statistically significant differences (P = 0.2060), as the averages of the evaluation times (P = 0.3955) and the interaction groups evaluation times (P = 0.3024), considering the MVO. The same occurred for RLE (P = 0.2988, P = 0.1762 and P = 0.7970), LLE (P = 0.3265, P = 0.4143 and P = 0.0696), PPTD (P = 0.1558, P = 0.4695 and P = 0.0737) and PPTE (P = 0.2376, P = 0.3203 and P = 0.0624). For PE, there were not statistically significant differences for groups (P = 0.7017) and the interaction groups evaluation times (P = 0.6678), even so in both groups the PE varied with time (P = 0.0069).     

Effects of exercise therapy on painful temporomandibular disorders

Temporomandibular disorders (TMD) are common chronic musculoskeletal pain conditions among orofacial pain. Painful TMD condition such as myalgia and arthralgia can be managed by exercise therapy. However, as it is hard to access actual effect of each modality that is included in an exercise therapy programme due to multiple choice of the management modality, their efficacy remains controversial. Therefore, this review focused on the effects of exercise therapy for the management of painful TMD. The aims of this review were to summarise the effects of exercise therapy for major symptoms of painful TMD and to establish a guideline for the management of painful TMD, resulting in higher quality and reliability of dental treatment. In this review, exercise modalities are clearly defined as follows: mobilisation exercise, muscle strengthening exercise (resistance training), coordination exercise and postural exercise. Furthermore, pain intensity and range of movements were focused as outcome parameters in this review. Mobilisation exercise including manual therapy, passive jaw mobilisation with oral appliances and voluntary jaw exercise appeared to be a promising option for painful TMD conditions such as myalgia and arthralgia. This review addressed not only the effects of exercise therapy on various clinical conditions of painful TMD shown in the past, but also an urgent need for consensus among dentists and clinicians in terms of the management of each condition, as well as terminology.     

肿痛安治疗癌症放射治疗后颞下颌关节疼痛的疗效评价

目的 评价肿痛安治疗癌症放射治疗后颞下颌关节疼痛的疗效.方法 选择癌症放射治疗后出现颞下颌关节疼痛的患者,试验组给予肿痛安口服,对照组分别给予布洛芬和维生素E口服,记录治疗前后的关节疼痛值与开口度,观察药物不良反应.结果 肿痛安与布洛芬口服后,关节疼痛程度均明显缓解,开口度增大,两种药物疗效之间差异无统计学意义.布洛芬引起的药物不良反应多于肿痛安,且两者之间差异有统计学意义.结论 肿痛安治疗癌症放射治疗后颞下颌关节疼痛疗效确切,相对于非甾体类消炎药,肿痛安的不良反应较少,安全系数高,可作为非甾体类消炎药不耐受患者的替代药物.     

Clinical factors affecting the outcome of occlusal splint therapy of temporomandibular joint disorders

The purpose of this study was to test the hypothesis that (1) the presence of a clinical temporomandibular joint-related disorder has effects on short-term changes in temporomandibular joint pain, and that (2) clinical variables of time since pain onset predict treatment outcomes of occlusal splint therapy. The study comprised 76 patients with unilateral temporomandibular joint pain. The clinical disorder subgroup included 47 patients with a clinical pain side-related diagnosis of internal derangement type I (n = 16), internal derangement type III (n = 19), and degenerative joint disease (n = 12). The clinical non-disorder subgroup consisted of 29 patients without a temporomandibular joint disorder. A logistic regression analysis was used to compute the odds ratio for the clinical variables of time since pain onset, adjusted for age, gender, pretreatment pain level, and clinical subgroup. For the temporomandibular joint pain measurements there was no significant 'session'/'clinical subgroup' interaction (P = 0.470). Significant increase in benefit of a successful outcome of 'pain reduction >70%' occurred with a time since pain onset of 2 years might belong to the unsuccessful treatment group of 'pain reduction <30%' was strong (6.0) and significant (P = 0.026). Diagnosis of temporomandibular joint disorder proved not to be linked to changes in therapeutic outcome measures of temporomandibular joint pain. Time since pain onset was an important prognostic determinant of successful occlusal splint therapy.     

Efficacy of low-level laser therapy in the treatment of temporomandibular disorder

AIMS: To evaluate the effectiveness of low-level laser therapy (LLLT) in patients presenting with temporomandibular disorder (TMD) in a random and placebo-controlled research design. METHODS: The sample consisted of 40 patients, divided into an experimental group (G1) and a placebo group (G2). The treatment was done with an infrared laser (830nm, 500mW, 20s, 4J/point) at the painful points, once a week for four consecutive weeks. The patients were evaluated before and after the treatment through a Visual Analogue Scale (VAS) and the Craniomandibular Index (CMI). RESULTS: The baseline and posttherapy values of VAS and CMI were compared by the paired T-test, separately for the placebo and laser groups. A significant difference was observed between initial and final values (p < 0.05) in both groups. Baseline and post-therapy values of pain and CMI were compared in the therapy groups by the two-sample T-test, yet no significant differences were observed regarding VAS and CMI (p > 0.05). CONCLUSION: After either placebo or laser therapy, pain and temporomandibular symptoms were significantly lower, although there was no significant difference between groups. The low-level laser therapy was not effective in the treatment of TMD, when compared to the placebo.     

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疼痛治疗分为药物治疗和非药物治疗。药物治疗包括非甾体类抗炎药、阿司匹林和扑热息痛等非阿片类镇痛药、阿片类镇痛药、"辅助"药物如抗抑郁药阿米替林和抗惊厥药卡马西平等。非药物治疗包括神经刺激疗法、神经阻滞疗法、外科手术、物理治疗、心理-行为疗法等。本文介绍我们临床上常见的颞下颌关节骨关节炎、肌筋膜疼痛、神经病理性疼痛(非典型牙痛、治疗后神经痛、三叉神经痛)及复合性局部疼痛综合征的主要临床用药和理论基础,如非甾体类抗炎药特异性COX-2抑制剂、改善骨关节炎症状和关节结构的药物硫酸氨基葡萄糖、阿片类药物曲马多、三环类抗抑郁药阿米替林、新一代抗惊厥药加巴喷丁等。