Evaluation Clinical Outcome of Maxillary Flat Occlusal Splint for Anterior Disc Displacement with Reduction of Temporomandibular Joint

使用上顎平坦型咬合板治療顳顎關節盤可復性前移的臨床評估

邱昶達(Chang-Ta Chiu) ； 莊晴雅(Ching-Ya Chuang) ； 張松文(Sung-Wen Chang) ； 李昭蓉(Jau-Rong Li) ； 邱馨儀(Hsin-Yi Chiu)

《中華民國家庭牙醫學雜誌》 4卷2期 (2009/09) Pp. 18-27

https://doi.org/10.6566/JFD/2009.4(2).18

摘要

臨床上咬合板被廣泛成功的使用在治療顳顎關節疾病症候群(TMD)，上顎平坦型咬合板可用來治療可復性關節盤前移(anterior disc displacement with reduction)與減輕相關的症狀。本研究主要目的在評估平坦型咬合板對患有顳顎關節彈響聲(clicking)合併有顳顎關節內部紊亂(internal derangement)造成的相關病症的治療成效。30位病患因患有單側顳顎關節彈響聲合併有耳前區疼痛而接受上額平坦型咬合板治療。每位病患於治療前後，都予以記錄最大張口度(MMO-maximal mouth opening)、疼痛區域、疼痛指數(VAS-visual analog scale)、罹患關節彈響聲病史時間，並以聽診器於患側耳前側區域聆聽與記錄關節彈響聲聲音的強弱程度。結果發現，採用上顯平坦型咬合板來治療患有顳顎關節彈響聲合併有顧額節區疼痛的病患，可改善其最大張口度，明顯的消除疼痛，更可以降低與消除顳顎關節彈響聲。臨床上在安靜的背景環境下，以聽診器的偵測加以分類彈響聲聲音強弱，不僅方便與簡易，更有助於臨床醫師對顳顎關節彈響聲臨床上治療效果的評估與追蹤。治療前顳顎關節彈響聲的嚴重度，也會影響治療的效果。

關鍵字

上顎平坦型咬合板 ； 顳顎關節彈響聲 ； 可復性關節盤前移 ； 聽診器

並列摘要

Clinically, the occlusal splint is widely used in the treatment of temporomandibular disorder (TMD) with relief of related symptoms. Maxillary flat occlusal splint can be used for the treatment of patients with anterior disc displacement with reduction. The objective of this study is to evaluate the treatment efficacy of the maxillary flat occlusal splint on symptoms associated with anterior disc displacement with reduction of the temporomandibular joint (TMJ). Thirty patients with unilateral anterior disc displaced with reduction concurrent with preauricular area pain were treated with maxillary flat occlusal splint. Pain free maximal mouth opening (MMO), pain score and duration of joint clicking sound were recorded for every patient before and after treatment. The degree of the joint clicking was detected by stethoscope at the anterolateral area of external auditory canal and recorded. Our results show that the maxillary flat occlusal splint can treat patients with anterior disc displacement with reduction of TMJ combined with preauricular area pain by improving MMO, significantly relieving pain, and decreasing or eliminating TMJ clicking. Clinically, the degree of the clicking sound can be detected and classified by stethoscope with a silent background. This method, which is easily performed, can benefit physicians in the evaluation and follow up of the clinical outcome of TMJ clicking.

並列關鍵字

Maxillary flat occlusal splint ； anterior disc displaced with reduction ； clicking ； stethoscope