Abstract：
OBJECTIVE: To evaluate the clinical effectiveness and stability of open suture versus micro-screw anchored disc reduction and fixation in treating disc displacement without reduction in the anterior temporomandibular joint.
METHODS: A total of 38 patients (51 sides) with anterior disc displacement without reduction (ADDwR) of the TMJ treated in our hospital from August 2021 to January 2023 were selected, including 19 cases in group A (23 sides) treated with open temporomandibular joint disc reduction and anchorage, and 19 cases in group B (28 sides) treated with temporomandibular joint disc reduction and suture. The Magnetic Resonance Imaging (MRI) data of the two groups before and after operation were compared to evaluate the effective rate of articular disc reduction, the change of articular disc length, The Maximal Interincisal Opening (MIO) and Numeric Rating Scale (NRS) were measured before and after operation.
RESULTS: In group A, the MRI effective rate 6 months after disc reduction was 95.65 % (22/23), the disc length gain was 1.74 mm, MIO was 40.32±5.067 mm, and NRS was 0.47±0.697. The MRI effective rate 6 months after disc reduction in group B was 100 % (28/28). The disc length gain was 1.78 mm, MIO was 41.58±3.746 mm, and NRS was 0.00. There was no significant difference between the two groups (P > 0.05).
CONCLUSIONS: TMJ disc reduction and suture and open TMJ disc anchorage can effectively reduce the TMJ disc. The TMJ disc stability is high at 6 months after operation, and the pain and mouth opening can be improved, which is worthy of further promotion in clinical practice.
METHODS: A total of 38 patients (51 sides) with anterior disc displacement without reduction (ADDwR) of the TMJ treated in our hospital from August 2021 to January 2023 were selected, including 19 cases in group A (23 sides) treated with open temporomandibular joint disc reduction and anchorage, and 19 cases in group B (28 sides) treated with temporomandibular joint disc reduction and suture. The Magnetic Resonance Imaging (MRI) data of the two groups before and after operation were compared to evaluate the effective rate of articular disc reduction, the change of articular disc length, The Maximal Interincisal Opening (MIO) and Numeric Rating Scale (NRS) were measured before and after operation.
RESULTS: In group A, the MRI effective rate 6 months after disc reduction was 95.65 % (22/23), the disc length gain was 1.74 mm, MIO was 40.32±5.067 mm, and NRS was 0.47±0.697. The MRI effective rate 6 months after disc reduction in group B was 100 % (28/28). The disc length gain was 1.78 mm, MIO was 41.58±3.746 mm, and NRS was 0.00. There was no significant difference between the two groups (P > 0.05).
CONCLUSIONS: TMJ disc reduction and suture and open TMJ disc anchorage can effectively reduce the TMJ disc. The TMJ disc stability is high at 6 months after operation, and the pain and mouth opening can be improved, which is worthy of further promotion in clinical practice.
摘要：
目的：评价开放缝合与微螺钉固定治疗颞下颌前关节不复位椎间盘移位的临床疗效和稳定性。
方法：选择2021年8月至2023年1月在我院治疗的38例（51侧）颞下颌关节前移位不复位（ADDwR）患者，A组19例(23侧)采用开放式颞下颌关节盘复位支抗,B组19例(28侧)采用颞下颌关节盘复位缝合治疗。比较两组患者手术前后的磁共振成像(MRI)数据,评价关节盘复位的有效率,关节盘长度的变化，术前和术后测量最大切口开口（MIO）和数字评定量表（NRS）。
结果：在A组中，椎间盘复位后6个月MRI有效率为95.65%(22/23),圆盘长度增益为1.74mm，MIO为40.32±5.067mm,NRS为0.47±0.697。B组椎间盘复位后6个月MRI有效率为100%(28/28)。圆盘长度增益为1.78mm，MIO为41.58±3.746mm,NRS为0.00。两组比较差异无统计学意义(P>0.05)。
结论：TMJ椎间盘复位缝合和开放TMJ椎间盘支抗可有效降低TMJ椎间盘。术后6个月TMJ椎间盘稳定性高,疼痛和张口可以得到改善，值得在临床上进一步推广。
方法：选择2021年8月至2023年1月在我院治疗的38例（51侧）颞下颌关节前移位不复位（ADDwR）患者，A组19例(23侧)采用开放式颞下颌关节盘复位支抗,B组19例(28侧)采用颞下颌关节盘复位缝合治疗。比较两组患者手术前后的磁共振成像(MRI)数据,评价关节盘复位的有效率,关节盘长度的变化，术前和术后测量最大切口开口（MIO）和数字评定量表（NRS）。
结果：在A组中，椎间盘复位后6个月MRI有效率为95.65%(22/23),圆盘长度增益为1.74mm，MIO为40.32±5.067mm,NRS为0.47±0.697。B组椎间盘复位后6个月MRI有效率为100%(28/28)。圆盘长度增益为1.78mm，MIO为41.58±3.746mm,NRS为0.00。两组比较差异无统计学意义(P>0.05)。
结论：TMJ椎间盘复位缝合和开放TMJ椎间盘支抗可有效降低TMJ椎间盘。术后6个月TMJ椎间盘稳定性高,疼痛和张口可以得到改善，值得在临床上进一步推广。
