关节盘形态学特征及盘髁角度对可复性关节盘前移位保守治疗效果的初步评价

doi:10.7518/hxkq.2025.2024313

华西口腔医学杂志 ›› 2025, Vol. 43 ›› Issue (3): 406-415.doi: 10.7518/hxkq.2025.2024313

关节盘形态学特征及盘髁角度对可复性关节盘前移位保守治疗效果的初步评价

宋佳璐(), 肖琦钦, 岑啸()

口腔疾病防治全国重点实验室国家口腔医学中心国家口腔疾病临床医学研究中心四川大学华西口腔医院颞下颌关节科，成都 610041

收稿日期:2024-08-23 修回日期:2024-12-11 出版日期:2025-06-01 发布日期:2025-06-10
通讯作者: 岑啸 E-mail:3400816728@qq.com;cenx@scu.edu.cn
作者简介:宋佳璐，学士，E-mail：3400816728@qq.com
基金资助:
四川大学华西口腔医学院（华西口腔医院）科研经费资助项目(RCDWJS2023-17)

Effect of disc morphological features and disc-condyle angles on conservative treatment for anterior disc displacement with reduction

Song Jialu(), Xiao Qiqin, Cen Xiao()

State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2024-08-23 Revised:2024-12-11 Online:2025-06-01 Published:2025-06-10
Contact: Cen Xiao E-mail:3400816728@qq.com;cenx@scu.edu.cn
Supported by:
Scientific Research Foundation of West China School of Stomatology (West China Hospital of Stomatology), Sichuan University(RCDWJS2023-17)

摘要/Abstract

摘要：

目的评估治疗前关节盘形态学特征及盘髁角度对前伸再定位咬合板（ARS）治疗可复性关节盘前移位（ADDwR）效果的影响。方法根据纳入排除标准共纳入11例ADDwR患者，分析ARS治疗前后核磁共振成像影像资料及Helkimo指数，评估治疗前患者关节盘长度、厚度、形态分类对患者治疗后临床症状及关节盘形态学特征、盘髁角度及临床症状的影响。结果经ARS治疗，所有ADDwR患者主观症状指数（Ai）和临床症状指数（Di）下降，关节盘长度增加，厚度降低。其中轻微前移位者或1型关节盘者Ai降至0且Di下降最明显，轻度前移位者（至8.65 mm±1.79 mm）或5型关节盘者（至10.71 mm±2.62 mm）长度增长最明显，轻微前移位者关节盘厚度降低最明显（至3.08 mm±0.51 mm）。结论 ARS治疗效果与关节盘移位程度及形态特征相关，为临床治疗决策提供了依据。

关键词: 前伸再定位咬合板, 可复性关节盘前移位, 关节盘, 核磁共振成像, 治疗效果

Abstract:

Objective This study aimed to evaluate the effect of disc morphology and disc-condyle angle on the treatment of anterior repositioning splint (ARS) for anterior disc displacement with reduction (ADDwR). Methods On the basis of the inclusion and exclusion criteria, a total of 11 patients diagnosed with ADDwR were included. The effects of changes in disc length, thickness, and morphology classifications on the clinical symptoms, disc morphology parameters, and disc-condyle angles after ARS treatment were evaluated using magnetic resonance imaging and the Helkimo index. Results After ARS treatment, the Ai and Di of all patients with ADDwR decreased, the disc length increased, and the thickness decreased. The Ai of patients with slight ADDwR and those with type 1 joint discs was reduced to 0, with the most significant decrease observed in Di. The disc length of mild ADDwR (increased to 8.65 mm±1.79 mm) and type 5 disc (increased to 10.71 mm±2.62 mm) significantly increased the most. The disc thickness of slight ADDwR decreased to 3.08 mm±0.51 mm significantly. Conclusion The therapeutic effect of ARS is correlated with the displacement degree and morphological features of the disc, providing evidence for clinical treatment decisions.

Key words: anterior repositioning splint, anterior disc displacement with reduction, disc, magnetic resonance imaging, therapeutic effect

中图分类号:

R782.6

宋佳璐, 肖琦钦, 岑啸. 关节盘形态学特征及盘髁角度对可复性关节盘前移位保守治疗效果的初步评价[J]. 华西口腔医学杂志, 2025, 43(3): 406-415.

Song Jialu, Xiao Qiqin, Cen Xiao. Effect of disc morphological features and disc-condyle angles on conservative treatment for anterior disc displacement with reduction[J]. West China Journal of Stomatology, 2025, 43(3): 406-415.

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前移位程度	治疗前/mm	治疗后/mm	P值
轻微	10.37±1.77	10.72±1.01	0.431
轻度	7.00±2.05	8.65±1.79	0.115
中度	7.17±2.02	9.01±3.80	0.376
总体	8.24±2.44	9.50±2.56	0.094

前移位程度	治疗前/mm	治疗后/mm	P值
轻微	3.42±0.96	3.08±0.51	0.308
轻度	2.27±1.30	2.25±1.28	0.958
中度	2.87±0.55	2.83±0.69	0.422
总体	2.95±1.01	2.74±0.89	0.212

形态	治疗前/mm	治疗后/mm	P值
1	10.17±1.89	10.42±1.19	0.579
2	7.42±3.31	7.86±0.97	0.859
4	7.88±2.16	7.93±3.44	0.969
5	7.03±2.05	10.71±2.62	0.067

形态	治疗前/mm	治疗后/mm	P值
1	3.15±0.99	3.01±0.66	0.641
2	1.43±0.99	1.51±0.83	0.563
4	3.18±0.77	2.67±0.83	0.325
5	3.10±0.83	3.15±0.73	0.583

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关节盘形态学特征及盘髁角度对可复性关节盘前移位保守治疗效果的初步评价

Effect of disc morphological features and disc-condyle angles on conservative treatment for anterior disc displacement with reduction

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