特发性髁突吸收的诊断和治疗：文献综述

IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Saudi Dental Journal Pub Date : 2024-11-01 DOI:10.1016/j.sdentj.2024.09.013

Yasser S. Alali , Khaled M. Al Habeeb , Khaled A. Al Malhook , Sami Alshehri

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引用次数: 0

摘要

背景和目的特发性髁状突吸收（ICR）可被描述为颞下颌关节（TMJ）的功能障碍重塑。它的临床特征是颞下颌关节的形态变化，包括臼齿高度降低、下颌加速后缩和青少年生长发育减慢。该病好发于 10 至 40 岁年龄组中的女性（90%），因此，ICR 的诊断和治疗是一项严峻的临床挑战。本研究旨在对 ICR 的诊断和治疗策略进行全面综述。材料和方法在 PubMed（Medline）数据库中根据 ICR 的相关关键词进行文献检索。结果通过文献检索确定了 253 篇文章。经过摘要筛选和全文审阅后，选择了 54 篇研究进行定性综合。综合临床和影像学检查结果、患者病史，并排除所有导致髁突吸收的已知局部/系统因素，即可确定ICR的诊断。ICR 的治疗取决于髁突的活动度以及外科医生保护关节盘和下颌髁突的能力，可以采用手术或非手术治疗。手术治疗可以是单纯的正颌手术，也可以是正颌手术和颞下颌关节手术的综合治疗。确定 ICR 的分期对于决定最佳治疗方案非常重要。早期的 ICR 可以通过正畸和夹板疗法进行非手术治疗，而晚期的 ICR 则需要同时进行颞下颌关节手术和正颌矫正以保持骨骼稳定。未来的研究应侧重于阐明 ICR 的潜在机制、完善诊断标准和优化治疗方案，以提高患者的治疗效果。

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Diagnosis and management of idiopathic condylar Resorption: A review of literature

Background and objectives

Idiopathic condylar resorption (ICR) can be described as a dysfunctional remodeling of the temporomandibular joint (TMJ). It is clinically characterized by morphological changes in TMJ including reduced ramus height, accelerated mandibular retrusion and reduced growth in juveniles. With a strong predilection towards females (90 %) within an age group of 10 to 40 years, diagnosis and management of ICR is a critical clinical challenge. The aim of this study is to present a comprehensive review of diagnosis and management strategies for ICR.

Materials and Methods

Literature search based on keywords relating to ICR was conducted on PubMed (Medline) database. Studies fulfilling the inclusion criteria (reports based on clinical diagnosis and management of ICR) were selected for comprehensive review.

Results

253 articles were identified through literature search. After abstract screening and full-text review, 54 studies were selected for qualitative synthesis. Diagnosis of ICR is established by combination of clinical and radiographic findings, patient history, and exclusion of all known local/systemic factors contributing to condylar resorption. Management of ICR depends on condylar activity and surgeon’s ability to preserve the articular disc and mandibular condyle, and could either be surgical or non-surgical. Surgical treatment can be either by orthognathic surgery alone or through a combination of orthognathic and TMJ surgeries.

Conclusion

Based on the present review, it may be concluded that diagnosis and management of ICR requires adequate clinical understanding of the condition. Identifying the stage of ICR is important in deciding optimum treatment plan. While early-stage ICR could be managed non-surgically by orthodontic and splint therapies, advanced stage disease require simultaneous TMJ Surgery with orthognathic correction for skeletal stability. Future research should focus on elucidating underlying mechanisms of ICR, refining diagnostic criteria, and optimizing treatment protocols to enhance patient outcomes.

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来源期刊

Saudi Dental Journal DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.60

自引率

0.00%

发文量

审稿时长

22 weeks

期刊介绍： Saudi Dental Journal is an English language, peer-reviewed scholarly publication in the area of dentistry. Saudi Dental Journal publishes original research and reviews on, but not limited to: • dental disease • clinical trials • dental equipment • new and experimental techniques • epidemiology and oral health • restorative dentistry • periodontology • endodontology • prosthodontics • paediatric dentistry • orthodontics and dental education Saudi Dental Journal is the official publication of the Saudi Dental Society and is published by King Saud University in collaboration with Elsevier and is edited by an international group of eminent researchers.