中国实用口腔科杂志

中国实用口腔科杂志 ›› 2024, Vol. 17 ›› Issue (2): 180-185.DOI: 10.19538/j.kq.2024.02.009

• 论著 • 上一篇    下一篇

数字化再定位咬合板治疗颞下颌关节盘可复性前移位临床效果研究

孙    浩，吴    璇，石    涛，邢文忠   

  1. 大连市口腔医院修复科，辽宁  大连  116021
  • 出版日期:2024-03-30 发布日期:2024-03-30

  • Online:2024-03-30 Published:2024-03-30

摘要： 目的    研究数字化再定位咬合板治疗颞下颌关节盘可复性前移位（anterior disc displacement with reduction，ADDwR）的临床效果。方法    选取2022年4—10月于大连市口腔医院颞下颌关节门诊就诊的ADDwR患者40例，按照随机数表法分为数字化组和传统组，每组20例。数字化组患者采用数字化再定位咬合板，传统组患者采用传统堆塑自凝树脂再定位咬合板，比较2组咬合板椅旁调改时间、治疗满意度评分、疼痛视觉模拟评分法（visual analogue scale，VAS）评分和颞下颌关节功能指标评分。结果    数字化组椅旁调改时间为（379.8 ± 91.0）s，明显短于传统组［（816.9 ± 102.0）s ］，差异有统计学意义（t = 14.301，P < 0.001）。治疗满意度评分越低表示患者越满意，数字化组在制作与戴入过程、外观影响、异味三方面评分低于传统组，差异均有统计学意义（均P < 0.05）。2组患者VAS评分、各项颞下颌关节功能指标评分比较，差异均无统计学意义（均P > 0.05）；数字化组和传统组治疗6个月后VAS评分分别为（1.71 ± 0.56）、（1.80 ± 0.40）分，相较于治疗前［（2.97 ± 0.83）、（2.94 ± 0.79）分］均有所下降，差异均有统计学意义（均P < 0.05）；与相同颞下颌关节功能指标治疗前评分比较，2组治疗6个月后均有所下降，差异均有统计学意义（均P < 0.05）。结论    与传统再定位咬合板相比，数字化再定位咬合板用于治疗ADDwR可获得相似的临床效果，且可提高临床效率及患者治疗满意度。

关键词: 关节盘可复性前移位, 再定位咬合板, 计算机辅助设计与制作

Abstract: Objective    To analyze the clinical effect of digital anterior repositioning splints on  anterior disc displacement with reduction. Methods    Totally 40 patients diagnosed with anterior disc displacement with reduction were included and randomly divided into 2 groups（digital group and traditional group，n = 20）. The patients in digital group were treated by digital anterior repositioning splints while those in traditional group were treated by traditional anterior repositioning splints mounted by self-curing resin. Time consuming of try-in，the patient-experience index，visual analogue scale （VAS） score and Fricton′s craniomandibular index were compared between the two groups. Results    Time consuming of try-in of the digital group was（379.8 ± 91.0）s，obviously less than that of the traditional group［（816.9 ± 102.0）s ］ with statistically significance. Lower patient-experience index indicated better patient satisfaction： the digital group obtained lower scores than traditional group in three aspects（the try-in experience，influence on appearance and the odour of the splints）with statistical significance（P < 0.05）. There were no statistically significant differences in the VAS scores or Fricton′s craniomandibular index scores between the two groups （P > 0.05）. The VAS of the digital and traditional group was（1.71 ± 0.56） and （1.80 ± 0.40） at 6 months after the treatment，obviously decreased when compared with that before treatment ［（2.97 ± 0.83），（2.94 ± 0.79）］，there being statistical significance（P < 0.05）. The Fricton′s craniomandibular index of both groups were significantly decreased after 6-month treatment（P < 0.05）. Conclusion    Digital anterior repositioning splints can achieve similar clinical effects when compared with the traditional anterior repositioning splints in the treatment of anterior disc displacement with reduction，with higher clinical efficiency and better patient experience. 

Key words: anterior disc displacement with reduction, anterior repositioning splint, computer-aided design and manufacturing