背景:关节负荷的减少是治疗颞下颌关节(TMJ)骨关节炎的潜在有益因素。本文旨在比较肌内注射肉毒杆菌毒素(BTX-A)作为TMJ关节穿刺术的辅助手段,关节穿刺术的粘性补充和单纯的粘性补充在TMJ骨关节炎的治疗中的有效性。
方法:一项先导临床回顾性研究检查了TMJ骨关节炎的治疗方法。患者分为两组:A组接受BTX-A注射和关节穿刺术并补充粘胶,而B组仅接受关节穿刺术并补充粘液剂。该研究根据张口(MO)评估结果,休息时疼痛(PR),咀嚼疼痛(PF),和不同时间点的咀嚼效率(ME)(基线(T0),1周(T1),2周(T2),3周(T3),和4周(T4))直至治疗后2个月。
结果:本研究包括两组,每人有5个病人。在第一次关节穿刺术预约期间,A组接受了五次每周一次的关节穿刺术加粘胶补充和一次BTX-A注射。B组接受了五次关节穿刺术和单纯粘胶的治疗方案。MO,PF,PR,两组在T2中ME迅速改善,但在接下来的几周内,A组的改善更加重要,并且持续的时间更长。
结论:关节穿刺术与BTX-A相关的黏性补充剂在改善临床结局方面比单独的关节穿刺术更有效。这表明患有TMJ骨关节炎和肌筋膜疼痛的患者可能受益于肌肉张力和关节负荷的降低。
BACKGROUND: The reduction in joint load is a potential beneficial factor in managing osteoarthritis of the temporomandibular joint (TMJ). This paper aims to compare the effectiveness of the intramuscular injection of botulinum toxin (BTX-A) as an adjunct to TMJ arthrocentesis plus viscosupplementation with arthrocentesis plus viscosupplementation alone in the management of TMJ osteoarthritis.
METHODS: A pilot clinical retrospective study examined TMJ osteoarthritis treatments. Patients were divided into two groups: Group A received BTX-A injections and arthrocentesis with viscosupplementation, while Group B received only arthrocentesis with viscosupplementation. The study assessed outcomes based on mouth opening (MO), pain at rest (PR), pain at mastication (PF), and masticatory efficiency (ME) at various time points (baseline (T0), 1 week (T1), 2 weeks (T2), 3 weeks (T3), and 4 weeks (T4)) up to 2 months after treatment.
RESULTS: The study included two groups, each with five patients. Group A received five weekly sessions of arthrocentesis plus viscosupplementation and a single BTX-A injection during the first arthrocentesis appointment. Group B underwent the five-session protocol of arthrocentesis plus viscosupplementation alone. MO, PF, PR, and ME improved quickly in T2 in both groups, but the improvement was of greater importance over the following weeks and lasted longer in Group A.
CONCLUSIONS: Arthrocentesis with viscosupplementation associated with BTX-A was found to be more effective than arthrocentesis alone in improving clinical outcomes. This suggests that patients with TMJ osteoarthritis and myofascial pain may benefit from reduced muscle tone and joint load.