{"title":"咬合夹板联合关节内注射透明质酸治疗颞下颌关节前盘不可复位移位的研究。","authors":"Ke Bi, Gang Cheng, Xiuyin Wu, Zhijun Lv","doi":"10.2147/TCRM.S518989","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of combining intra-articular injection of hyaluronic acid (HA) with occlusal splint therapy in the treatment of non-reducible anterior disc displacement of the temporomandibular joint (ADDWoR).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 62 patients with ADDWoR admitted to our hospital from April 2023 to June 2024. According to the treatment method received, patients were divided into a control group (n=31, treated with occlusal splints) and an observation group (n=31, treated with occlusal splints combined with intra-articular injection of HA). The clinical treatment effects, pain levels (Visual Analog Scale [VAS]), temporomandibular joint dysfunction (Friction Temporomandibular Joint Dysfunction Index [CMI]), mandibular movement function (maximum mouth opening [MMO], left lateral excursion [LLE], right lateral excursion [RLE], protrusive movement [PM]), clinical aesthetic indicators (condylar height, joint space width), and adverse reactions were compared between the two groups.</p><p><strong>Results: </strong>(1) Clinical Efficacy: The observation group had a higher total effective rate (90.32% vs 67.74%, P < 0.05). (2) Pain & Dysfunction: Both groups showed significant improvement in VAS and CMI scores over time, with the observation group exhibiting greater reductions (P < 0.05). (3) Mandibular Function & Aesthetic Indicators: The observation group had greater improvements in MMO, LLE, RLE, PM, condylar height, and joint space width (P < 0.05). (4) Adverse Reactions: No significant difference in adverse reaction rates (P > 0.05).</p><p><strong>Conclusion: </strong>The combination of intra-articular injection of HA with occlusal splint therapy can further improve the treatment outcomes for ADDWoR patients, alleviate pain, improve temporomandibular joint dysfunction and mandibular movement function, promote aesthetic recovery, and does not increase the risk of adverse reactions.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"523-532"},"PeriodicalIF":2.8000,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035411/pdf/","citationCount":"0","resultStr":"{\"title\":\"Study on the Combined Application of Occlusal Splint and Intra-Articular Injection of Hyaluronic Acid in the Treatment of Non-Reducible Anterior Disc Displacement of the Temporomandibular Joint.\",\"authors\":\"Ke Bi, Gang Cheng, Xiuyin Wu, Zhijun Lv\",\"doi\":\"10.2147/TCRM.S518989\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate the effect of combining intra-articular injection of hyaluronic acid (HA) with occlusal splint therapy in the treatment of non-reducible anterior disc displacement of the temporomandibular joint (ADDWoR).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 62 patients with ADDWoR admitted to our hospital from April 2023 to June 2024. According to the treatment method received, patients were divided into a control group (n=31, treated with occlusal splints) and an observation group (n=31, treated with occlusal splints combined with intra-articular injection of HA). The clinical treatment effects, pain levels (Visual Analog Scale [VAS]), temporomandibular joint dysfunction (Friction Temporomandibular Joint Dysfunction Index [CMI]), mandibular movement function (maximum mouth opening [MMO], left lateral excursion [LLE], right lateral excursion [RLE], protrusive movement [PM]), clinical aesthetic indicators (condylar height, joint space width), and adverse reactions were compared between the two groups.</p><p><strong>Results: </strong>(1) Clinical Efficacy: The observation group had a higher total effective rate (90.32% vs 67.74%, P < 0.05). (2) Pain & Dysfunction: Both groups showed significant improvement in VAS and CMI scores over time, with the observation group exhibiting greater reductions (P < 0.05). (3) Mandibular Function & Aesthetic Indicators: The observation group had greater improvements in MMO, LLE, RLE, PM, condylar height, and joint space width (P < 0.05). 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引用次数: 0
摘要
目的：探讨关节内注射透明质酸（HA）联合咬合夹板治疗颞下颌关节前盘不可还原性移位的疗效。方法：回顾性分析我院2023年4月至2024年6月收治的62例adwor患者的临床资料。根据所接受的治疗方法将患者分为对照组（31例，采用咬合夹板治疗）和观察组（31例，采用咬合夹板联合关节内注射HA治疗）。比较两组患者的临床治疗效果、疼痛程度（视觉模拟量表[VAS]）、颞下颌关节功能障碍（摩擦颞下颌关节功能障碍指数[CMI]）、下颌运动功能（最大开口[MMO]、左外侧偏移[LLE]、右外侧偏移[RLE]、突出运动[PM]）、临床美学指标（髁突高度、关节间隙宽度）及不良反应。结果：(1)临床疗效：观察组总有效率高于对照组（90.32% vs 67.74%, P < 0.05）。(2)疼痛与功能障碍：两组患者VAS、CMI评分随时间推移均有显著改善，其中观察组降低幅度更大（P < 0.05）。(3)下颌功能及美观指标：观察组患者的MMO、LLE、RLE、PM、髁突高度、关节间隙宽度均有较大改善（P < 0.05）。(4)不良反应：不良反应发生率差异无统计学意义（P < 0.05）。结论：关节内注射HA联合咬合夹板治疗可进一步改善ADDWoR患者的治疗效果，减轻疼痛，改善颞下颌关节功能障碍和下颌运动功能，促进美观恢复，且不增加不良反应的发生风险。
Study on the Combined Application of Occlusal Splint and Intra-Articular Injection of Hyaluronic Acid in the Treatment of Non-Reducible Anterior Disc Displacement of the Temporomandibular Joint.
Objective: To investigate the effect of combining intra-articular injection of hyaluronic acid (HA) with occlusal splint therapy in the treatment of non-reducible anterior disc displacement of the temporomandibular joint (ADDWoR).
Methods: A retrospective analysis was conducted on the clinical data of 62 patients with ADDWoR admitted to our hospital from April 2023 to June 2024. According to the treatment method received, patients were divided into a control group (n=31, treated with occlusal splints) and an observation group (n=31, treated with occlusal splints combined with intra-articular injection of HA). The clinical treatment effects, pain levels (Visual Analog Scale [VAS]), temporomandibular joint dysfunction (Friction Temporomandibular Joint Dysfunction Index [CMI]), mandibular movement function (maximum mouth opening [MMO], left lateral excursion [LLE], right lateral excursion [RLE], protrusive movement [PM]), clinical aesthetic indicators (condylar height, joint space width), and adverse reactions were compared between the two groups.
Results: (1) Clinical Efficacy: The observation group had a higher total effective rate (90.32% vs 67.74%, P < 0.05). (2) Pain & Dysfunction: Both groups showed significant improvement in VAS and CMI scores over time, with the observation group exhibiting greater reductions (P < 0.05). (3) Mandibular Function & Aesthetic Indicators: The observation group had greater improvements in MMO, LLE, RLE, PM, condylar height, and joint space width (P < 0.05). (4) Adverse Reactions: No significant difference in adverse reaction rates (P > 0.05).
Conclusion: The combination of intra-articular injection of HA with occlusal splint therapy can further improve the treatment outcomes for ADDWoR patients, alleviate pain, improve temporomandibular joint dysfunction and mandibular movement function, promote aesthetic recovery, and does not increase the risk of adverse reactions.
期刊介绍：
Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas.
The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature.
As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication.
The journal does not accept study protocols, animal-based or cell line-based studies.
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