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目的:研究两种咬合板治疗深覆伴颞下颌关节不可复性盘前移位患者的疗效对比。方法:选择深覆伴不可复性盘前移位患者28例,分为两组,稳定型咬合板(stable bite plate,SBP)组,观察对象19例,行SBP治疗;松弛型咬合板(relaxation splint,RS)组,观察对象9例,行RS治疗。观察患者治疗前及治疗后第2周、4周、6周、8周、12周疼痛分级指数(VAS)、最大开口度、关节弹响的变化以及CBCT影像学变化。结果:2组治疗后VAS值均明显低于治疗前,2组之间差异无统计学意义(P>0.05)。最大开口度及关节弹响均较治疗前有所改善,2组结果比较差异无统计学意义(P>0.05)。CBCT显示2组关节前间隙均较治疗前减小并且髁突表面有所改建。结论:对于深覆伴不可复性盘前移位患者,SBP和RS均能缓解咀嚼肌紧张状态,并减轻疼痛,但是稳定型咬合板较松弛型咬合板适用范围广,临床应用较多。
Objective: To study the curative effect of two kinds of occlusal plates for the treatment of deep overburden with inflexible temporomandibular joint incontinence. Methods: Twenty-eight patients with deep supraspinatus and nonreplicable disc anterior displacement were divided into two groups: stable bite plate (SBP) group, 19 cases undergoing SBP treatment; relaxation splint, RS) group, observed in 9 cases, the treatment of RS. The changes of pain grading index (VAS), maximal opening degree, joint snapping and CBCT imaging were observed before and after treatment in patients at 2 weeks, 4 weeks, 6 weeks, 8 weeks and 12 weeks after treatment. Results: The VAS values of two groups after treatment were significantly lower than those before treatment. There was no significant difference between the two groups (P> 0.05). The maximal degree of opening and snapping were all improved compared with that before treatment. There was no significant difference between two groups (P> 0.05). CBCT showed that the anterior joint space of both groups was decreased and the condylar surface was remodeled before treatment. CONCLUSIONS: SBP and RS can relieve the masticatory muscle tension and relieve pain in patients with deep overgrowth complicated with preoperative disc anterior displacement. However, stable occlusal plate is more suitable for a wide range of clinical applications.