应用颞颌关节镜治疗颞颌关节盘前移位的临床研究

目的：探讨颞颌关节镜治疗颞颌关节不可复性盘前移位的临床应用效果。方法：对98例颞颌关节不可复性盘前移位患者分别采用颞颌关节镜进行关节盘前松解复位灌洗、关节上腔粘连松解灌洗、单纯关节上腔灌洗等治疗方法,通过观察疼痛程度、张口度及侧向运动度的改变,评价其临床疗效。结果：灌洗治疗后患者张口度、侧向运动度和疼痛程度较治疗前均明显改善。关节盘前松解复位灌洗组和粘连松解灌洗组治疗后疼痛减少值、张口度及侧向运动度增加值明显高于单纯灌洗组。关节盘前松解复位灌洗组在张口度增加值及疼痛减少值的改变优于粘连松解灌洗组。结论：关节上腔灌洗可以作为颞颌关节内紊乱疾病的有效治疗方法,而针对不可复性盘前移位的患者,颞颌关节镜下关节盘前松解复位灌洗治疗则具有更好的疗效。

Clinical Study Of Arthroscopic Surgery for the Treatment of Anterior Disc Displacement Without Reduction of Temporomandibular Disorders

Objective：To evaluate the clinical efficacy of arthroscopic surgery for the treatment of anterior disc displacement without reduction（ADDWoR）of temporomandibular disorders.Methods：22 cases were treated with anterior release and restore of disc and lavage and 46 cases were treated with lysis and lavage by using temporomandibular joint（TMJ）arthroscopy,30 cases were treated with lavage.The clinical effects of three treatment groups were compared.Results：The mouth opening and jaw side-winding were increased and the pain intensity was reduced in arthroscopic surgery groups.The success rates had increased significantly（P0.01）.Conclusion：Arthroscopic surgery is effective for the treatment of ADDWoR.It is recommended as a simple alternative to temporomandibular disorders.