使用平坦型咬合板治療顳顎關節盤可復性前移的臨床評估

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

邱昶達(C. T. Chiu) ； 莊晴雅(C. G. Chuang) ； 劉巡宇(S. Y. Liu) ； 顏欽堉(C. Y. Yen) ； 蔣維凡(W. F. Chiang) ； 廖國安(G. A. Liaw) ； 張松文(S. W. Chang)

《中華民國口腔顎面外科學會雜誌》 17卷2期 (2006/09) Pp. 92-100

https://doi.org/10.7104/CJOMS.200609.0092

摘要

臨床上咬合板被廣泛的使用在治療顳顎關節的可復性關節盤前移(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。15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，採用平坦型咬合板來治療患有顳顎關節彈響聲合併有顳顎節區疼痛的病患，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。治療前關節彈響聲的嚴重度，也會影響治療的效果。

關鍵字

顳顎關節彈響聲 ； 平坦型咬合板 ； 疼痛指數

並列摘要

Occlusal splints have widely clinically succeeded in treating the anterior disc displacement with reduction of temporomandibular joint (TMJ) and reducing the associated symptoms. The study aimed at assessing maxillary flat occlusal splint therapy for patients with the pertinent signs caused by TMJ clicking complicated with the internal derangement. The 15 patients with TMJ clicking sound complicated with the joint pain who had accepted flat occlusal splint therapy. Before and after individual treatment, the maximum mouth opening (MMO), pain area, visual analogue scale (VAS) pain score, clicking duration, and clicking sound volumes detected by the stethoscope placed on the external acoustic meatus were recorded. Resultantly, the mentioned splints for treating TMJ clicking complicated with the joint pain improved MMO, prominently relieved pain, reduced and eliminated the joint clicking sounds, and due to the different sound volumes detected stethoscopically is convenient, easy and conducive for clinical doctors to evaluate and follow up the effect.

並列關鍵字

Temporomandibular join clicking ； Flat occlusal splint ； Pain score