Clinical efficacy of intra-articular ozone gas bath therapy combined with physiotherapy on temporomandibular anterior disc displacement without reduction

doi:10.19438/j.cjoms.2021.02.005

Abstract

Abstract: PURPOSE: To explore the clinical efficacy of intra-articular ozone gas bath therapy combined with physiotherapy on temporomandibular anterior disc displacement without reduction(ADDwoR). METHODS: Fifty-four patients diagnosed with ADDwoR were randomized into the experimental group (27 cases) and control group (27 cases). Patients in the two groups respectively underwent intra-articular ozone gas bath and sodium hyaluronate(SH) injection, once a week for 3 weeks, simultaneously combined with physical therapy modalities which included patients education, mandibular manipulation technique, passive training with open mouth. The visual analogue scale (VAS) of pain, mandibular movements, and efficiency of the two groups were assessed after 1, 3 months of follow-up. SPSS 21.0 software package was used for data analysis. RESULTS: The pain intensity and mandibular movements improved significantly compared to these of pre-treatment in both groups (P<0.05), with no significant intra-group difference (P>0.05). There was no significant difference in the total effective rate between the two groups (P>0.05). CONCLUSIONS: Intra-articular ozone gas bath therapy combined with physiotherapy can provide symptomatic relief on ADDwoR, similar to the efficacy of SH combination; however, it could be a cheaper clinical alternative.

Key words: Temporomandibular joint disc, Ozone, Hyaluronic acid, Physical therapy modality

CLC Number:

R782.6

YANG Ping-ping, XI Peng, WANG Jing, GUO Jin-jin, SHENG Guang, MAIMAITITUXUN Tuerdi. Clinical efficacy of intra-articular ozone gas bath therapy combined with physiotherapy on temporomandibular anterior disc displacement without reduction[J]. China Journal of Oral and Maxillofacial Surgery, 2021, 19(2): 121-125.

References

[1] 陈慧敏, 傅开元, 张震康. 颞下颌关节紊乱病症状、体征与患者生活质量的关系[J]. 中华口腔医学杂志, 2007, 42(3): 173-175.
[2] 陈启林, 徐晓明, 艾俊, 等. 玻璃酸钠关节腔注射结合被动张口训练治疗颞下颌关节不可复性盘前移位的临床研究[J]. 临床口腔医学杂志, 2015, 31(6): 377-380.
[3] Dernek B, Kesiktas FN.Efficacy of combined ozone and platelet-rich-plasma treatment versus platelet-rich-plasma treatment alone in early stage knee osteoarthritis[J]. J Back Musculoskelet Rehabil, 2019, 32(2): 305-311.
[4] Oliviero A, Giordano L, Maffulli N.The temporal effect of intra-articular ozone injections on pain in knee osteoarthritis[J]. Br Med Bull, 2019, 132(1): 33-44.
[5] Celakil T, Muric A, Gökcen Roehlig B, et al.Management of pain in TMD patients: Bio-oxidative ozone therapy versus occlusal splints[J]. Cranio, 2019, 37(2): 85-93.
[6] Özalp Ö, Yildirimyan N, Sindel A, et al.Evaluation of the short-term efficacy of transdermal ozone therapy in Turkish patients with internal derangement of the temporomandibular joint[J]. Pesquisa Brasileira em Odontopediatria e Clínica Integrada, 2019, 19(1): 1-10.
[7] 邓力, 张清彬, 张颖, 等. 臭氧治疗颞下颌关节炎的临床研究[J]. 口腔医学研究, 2016, 32(11): 1208-1210.
[8] 谷志远, 傅开元, 张震康. 颞下颌关节紊乱病[M]. 北京: 人民卫生出版社, 2008: 261-264.
[9] 孙海涛, 关家文, 贾逢爽, 等. 关节腔内臭氧浴法治疗膝关节骨性关节炎临床研究[J]. 中国疼痛医学杂志, 2009, 15(3): 183-185.
[10] 徐丽丽, 蔡斌, 方仲毅, 等. 个体化综合物理疗法治疗颞下颌关节紊乱病的疗效观察[J]. 中华物理医学与康复杂志, 2014, 36(5): 329-322.
[11] Nasri-Heir C, Epstein JB, Touger-Decker R, et al.What should we tell patients with painful temporomandibular disorders about what to eat?[J]. J Am Dent Assoc, 2016, 147(8): 667-671.
[12] 胡阿特·哈德尔, 周伟, 帕尔哈提·艾买提, 等. 小针刀联合运动疗法治疗颞下颌关节盘不可复性前移位的效果评价[J]. 中国口腔颌面外科杂志, 2019, 17(4): 327-331.
[13] Haketa T, Kino K, Sugisaki M, et al.Randomized clinical trial of treatment for TMJ disc displacement[J]. J Dent Res, 2010, 89(11): 1259-1263.
[14] 严广斌. 视觉模拟评分法[J]. 中华关节外科杂志(电子版), 2014, 8(2): 273-273.
[15] Tatli U, Benlidayi ME, Ekren O, et al.Comparison of the effectiveness of three different treatment methods for temporomandibular joint disc displacement without reduction[J]. Int J Oral Maxillofac Surg, 2017, 46(5): 603-609.
[16] 邹幸文, 张亚平, 陈达成. 硫酸氨基葡萄糖胶囊联合盐酸利多卡因注射液治疗颞下颌关节紊乱综合征疗效观察[J]. 中国药业, 2019, 28(23): 52-54.
[17] 张震, 王晓飞. 透明质酸及其在口腔颌面外科领域的研究应用[J]. 口腔医学, 2020, 40(2): 176-179.
[18] Yilmaz O, Korkmaz YT, Tuzuner T.Comparison of treatment efficacy between hyaluronic acid and arthrocentesis plus hyaluronic acid in internal derangements of temporomandibular joint[J]. J Craniomaxillofac Surg, 2019, 47(11): 1720-1727.
[19] 方仲毅, 范帅, 蔡斌,等. 256例慢性颞下颌关节盘不可复性前移位综合物理治疗远期疗效评价[J]. 上海口腔医学, 2018, 27(3):289-292.
[20] 赵旭, 傅志俭. 医用臭氧临床应用和安全性研究进展[J]. 中国疼痛医学杂志, 2018, 24(7): 489-492.
[21] 韦英成, 梁晓行, 吴肖梅. 臭氧在临床疼痛医学中的应用及研究进展[J]. 中国全科医学, 2020, 23(23): 2969-2974.
[22] 胡炳炎, 艾金伟, 刘楚繁. 臭氧与透明质酸治疗膝骨性关节炎安全性和有效性的Meta分析[J]. 重庆医学, 2017, 46(9): 1240-1248.
[23] 薛艳, 庞晓林, 何军. 不同疗程医用臭氧关节内注射对兔膝骨关节炎疗效比较[J]. 中国疼痛医学杂志, 2019, 25(11): 871-875.
[24] 黑光, 李剑峰, 张君, 等. 臭氧水治疗膝骨关节炎的临床疗效及对关节液细胞因子的影响[J]. 中国疼痛医学杂志, 2020, 26(2): 150-152.
[25] 谷志远, 张震康, 马绪臣. 颞下颌关节腔注射治疗及其理论基础[J]. 中华口腔医学杂志, 2002, 37(6): 475-477.
[26] 马绪臣. 对颞下颌关节紊乱病关节盘移位的认识及治疗策略[J]. 中华口腔医学杂志, 2017, 52(3): 139-142.