- 期刊
咬合板治療顳顎關節盤可復位性前移位的成效及相關因子影響性之探討
The Effect of Occlusal Splint Therapy for Anterior Disc Displacement with Reduction of the TMJ and Evaluation of Associated Factors
摘要
患有顳顎關節盤可復性前移位病患常飽受開閉口時關節聲響之苦，此外可能併發開閉口路徑偏斜、關節發炎腫痛及開口受限無法順利張嘴等問題。基於此，本研究探討咬合板對關節盤可復性前移位的治療療效，並分析和關因子對治療的影響。本研究收錄48位臨床上診斷為關節盤可復性前移位病患，總關節數50個。每位病患皆接受咬合板治療及拍攝核磁共振影像以確立疾病診斷，並定期追踪記錄直至治療療程結束。於治療療程結束後半年時間，本研究追踪30位當初核磁共振影像確立診斷為顳顎關節盤可復性前移位的病患（總關節數32個），再次收集相關臨床資料，進而探討此30位病患的半年後成功率以及是否受相關因子影響。初始50個關節影像中，40個診斷等同於臨床診斷，臨床診斷準確率達80.0％。治療結束而半年後追踪的32個關節中，治療成功率達62.5％。此外將各個因子分層，並以Fisher's exact test及Chi-square test探討此些因子和治療成功率的關係時，並無任一因子有統計上顯著的意義。本研究結果中，證實咬合板確實對顳顎關節盤可復性前移位有療效存在。此外在臨床上，以關節彈響或間歇性卡住合併壓舌板測試法作為診斷方法及決定咬合板治療位置時，結果顯現其準確性很高。最後本研究探討的各項因子和治療成功率，雖然並無統計上顯著相關性存在，但於此提供此些因子給各位參考，期望將來可朝此方面進一步研究討論。
並列摘要
Patients who suffered from anterior disc displacement with reduction of temporomandibular joint (ADDR) always bore clicking soundwhich embarrassed them. Besides, ADDR may accompany with painful inflammation of joint and deviation or intermittent locking during mouth opening and closing. Because of these troublesome symptom and sign, the present study was to evaluate the effect of occlusal splint for treatment of ADDR and analyzed associated factors which may influence on it.The study recruited 48 consecutive patients who clinically were diagnosed as ADDR. The total numbers of participated joint were 52. All of the patients received occlusal splint treatment and magnetic resonance imaging (MRI) taking to confirm the diagnosis and were followed up until the course of treatment completed. After course of splint treatment accomplished and passing half a year, we traced 30 patients who initially were diagnosed as ADDR by MRI and collected the clinical data again. Then we discussed the success rate of occlusal splint and analyzed if the success rate was influenced by the associated factors.Initially, the 50 joints clinically diagnosed as ADDR were confirmed in 40 joints. The accuracy of the clinically diagnostic method for ADDR used in the present study was 80.0%. After half a year in the traced 32 joints, the success rate of occlusal splint was 62.5%. Furthermore, when we divided the associated factors into subgroups and utilized the Fisher's exact test and Chi-square test to analyze the correlation between treatment outcomes and factors, there was statistically insignificant in the results.In the present study, the result confirmed the good efficacy of occlusal splint to treat anterior disc displacement with reduction of TMJ disc. In addition, we used the clicking sound and intermittent locking as guideline for diagnosis and design of splint, and the result showed it's a reliable method. Although the result in the present study didn't show any statistical significance, here we provided some factors for further study to investigate.