CAJ | 학술논문

目的分析透明质酸(hyaluronic acid,HA)关节腔注射及关节盘修补术两种方法治疗颞下颌关节盘穿孔的效果.方法随访分别采用透明质酸注射治疗的28例(38侧,HA组)及关节盘修补术治疗的20例(29侧,手术组)颞下颌关节盘穿孔患者,比较治疗前及治疗后3、9个月时最大开口度、疼痛及髁突骨质变化.结果两组患者治疗后3及9个月开口度均较治疗前显著增大,HA组开口度增大平均5.89、7.64 mm;手术组增大2.75、6.10 mm,同时疼痛缓解,临床症状减轻,差异均有统计学意义(P＜0.05).髁突有骨质修复性改建:HA组66％(25/38),手术组55％(16/29).结论透明质酸注射及关节盘修补术均能有效缓解关节盘穿孔患者的临床症状.
목적 분석투명질산(hyaluronic acid,HA)관절강주사급관절반수보술량충방법치료섭하합관절반천공적효과.방법 수방분별채용투명질산주사치료적28례(38측,HA조)급관절반수보술치료적20례(29측,수술조)섭하합관절반천공환자,비교치료전급치료후3、9개월시최대개구도、동통급과돌골질변화.결과 량조환자치료후3급9개월개구도균교치료전현저증대,HA조개구도증대평균5.89、7.64 mm;수술조증대2.75、6.10 mm,동시동통완해,림상증상감경,차이균유통계학의의(P＜0.05).과돌유골질수복성개건:HA조66％(25/38),수술조55％(16/29).결론 투명질산주사급관절반수보술균능유효완해관절반천공환자적림상증상.
Objective To assess the efficacy of injection of sodium hyaluronate in the treatment of patients with disc perforation by using cone-beam computed tomography (CBCT) and temporomandibular joint (TMJ) function.Methods Twenty-eight patients (38 joints) with disc perforation observed through arthrography who received injection of sodium hyaluronate and other 20 patients (29 joints) who received disc repair were included in this study.Pain (visual analog scale,scores 0 to 100),maximal mouth opening,modified Helkimo's clinical dysfunction index and TMJ examinations with CBCT were obtained before and 3,9 months after treatment.Results A statistically significant increase (P＜0.05) in TMJ clinical outcome was observed at each follow-up.The maximal mouth opening (MMO) increased 5.89 mm and 7.64 mm at 3 and 9 months follow-up in the hyaluronic acid (HA) group,and the MMO increased 2.75 mm and 6.10 mm at 3 and 9 months follow-up in the operation group.Osseous remodeling occurred in 66％ (25 of 38 joints) of patients after HA injection and 55％(16 of 29 joints) of patients appeared bone remodeling after disc repair.Conclusions Both injection of hyaluronic acid and disc repair are effective for treatment of temporomandibular joint disc perforation.