牵伸支具对颞下颌关节盘锚固术后患者开口受限的作用评价

doi:10.19438/j.cjoms.2022.01.007

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (1): 37-41.doi: 10.19438/j.cjoms.2022.01.007

牵伸支具对颞下颌关节盘锚固术后患者开口受限的作用评价

范帅¹, 蔡斌^1,*, 何冬梅^2,*, 徐丽丽¹, 陆沈吉¹, 方仲毅¹

1.上海交通大学医学院附属第九人民医院康复医学科,2.口腔外科,上海 200011

收稿日期:2021-05-15 修回日期:2021-08-04 出版日期:2022-01-20 发布日期:2022-01-20
通讯作者: 蔡斌,E-mail: shrehab@163.com;何冬梅,E-mail: lucyhe119@163.com。^*共同通信作者
作者简介:范帅（1987-）,男,硕士康复治疗师,E-mail: shuaifantasy@163.com
基金资助:
上海市科学技术委员会“科技创新行动计划” 生药支撑项目（19441908400）; 上海交通大学医学院附属第九人民医院临床研究助推计划（JYLJ201901）

Effect of stretching devices on mouth opening limitation in patients after temporomandibular joint disc anchoring

FAN Shuai¹, CAI Bin¹, HE Dong-mei², XU Li-li¹, LU Shen-ji¹, FANG Zhong-yi¹

1. Department of Rehabilitation Medicine, 2. Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China

Received:2021-05-15 Revised:2021-08-04 Online:2022-01-20 Published:2022-01-20

摘要/Abstract

摘要： 目的: 探讨颞下颌关节盘不可复性前移位患者行关节盘复位锚固术后,使用颞下颌关节牵伸支具治疗开口受限的疗效。方法: 选择67例颞下颌关节盘锚固术后开口受限患者,其中支具牵伸组32例,对照组35例。对照组进行常规居家康复训练,支具组接受常规居家康复训练加颞下颌关节牵伸支具牵伸。评估患者治疗前与治疗6周后的最大主动开口度、疼痛评分以及下颌功能受限评分（JFLS-8）。采用SPSS 17.0软件包进行统计学分析。结果: 随访结果显示,2组患者最大开口度与下颌功能受限评分均显著改善。支具组最大主动开口度（36.7 mm）显著大于对照组（29.1 mm,P<0.05）,支具组JFLS-8评分（7.3）显著低于对照组（11.2,P<0.05）。结论: 牵伸支具的使用对颞下颌关节盘锚固术后患者开口度增加及功能改善有很好疗效,值得临床推广应用。

关键词: 颞下颌关节, 关节盘锚固术, 开口受限, 牵伸

Abstract: PURPOSE: To observe the effects of jaw stretching devices in the treatment of limited mouth opening in patients with temporomandibular joint(TMJ) disc displacement without reduction after disc anchoring. METHODS: Sixty-seven patients with limited mouth opening after TMJ disc anchorage were followed up, including 32 patients in the stretching device group and 35 patients in the control group. Patients in the control group were given home rehabilitation training, while patients in the stretching devices group were given jaw stretching device training combined with home rehabilitation training. The maximum active mouth opening, pain evaluated with visual analog scale (VAS), jaw functional limitation scale-8(JFLS-8) were evaluated before and 6 weeks after treatment. Statistical analysis of the data was performed with SPSS 17.0 software package. RESULTS: The follow-up results showed that the maximum mouth opening and JFLS-8 of the two groups were significantly improved. The maximum active mouth opening of the stretching device group (36.7 mm) was significantly better than that of the control group (29.1 mm, P<0.05), JFLS-8 of the stretching device group (7.3) was significantly lower than that of the control group (11.2, P<0.05). CONCLUSIONS: The use of jaw stretching devices has a good effect on the increase of mouth opening and improvement of function in patients with TMJ after disc anchoring, which is worthy of clinical application.

Key words: Temporomandibular joint, Disc anchoring, Limited mouth opening, Stretch

中图分类号:

R782.6

范帅, 蔡斌, 何冬梅, 徐丽丽, 陆沈吉, 方仲毅. 牵伸支具对颞下颌关节盘锚固术后患者开口受限的作用评价[J]. 中国口腔颌面外科杂志, 2022, 20(1): 37-41.

FAN Shuai, CAI Bin, HE Dong-mei, XU Li-li, LU Shen-ji, FANG Zhong-yi. Effect of stretching devices on mouth opening limitation in patients after temporomandibular joint disc anchoring[J]. China J Oral Maxillofac Surg, 2022, 20(1): 37-41.

参考文献

[1] 张善勇, 张晓虎, 霍亮,等. 改良颞下颌关节盘锚固术-技术介绍[J]. 中国口腔颌面外科杂志, 2012, 10(6):478-483.
[2] 朱慧敏, 周琴, 何冬梅,等. 关节盘复位锚固术术后稳定性的影像学评价[J]. 中国实用口腔科杂志,2018,11(12):731-734.
[3] 刘登峰, 孙仁义, 肖进,等. 关节盘锚固定术治疗颞下颌关节盘前移位的临床应用[J]. 口腔医学,2015,35(8):658-662.
[4] Liu X, Zhou Z, Mao Y, et al.Temporomandibular joint anchorage surgery: a 5-year follow-up study[J]. Sci Rep, 2019, 9(1):19106.
[5] De Meurechy NKG, Loos PJ, Mommaerts MY.Postoperative physiotherapy after open temporomandibular joint surgery: a 3-step program[J]. J Oral Maxillofac Surg, 2019,77(5):932-950.
[6] 甄锦泽, 张善勇, 杨驰, 等. 改良颞下颌关节盘锚固术常见并发症的防治[J]. 中国口腔颌面外科杂志,2016, 14(2):158-161.
[7] Kamstra J, van Leeuwen M, Roodenburg J, et al. Exercise therapy for trismus secondary to head and neck cancer: a systematic review[J]. Head Neck, 2017,39(11):2352-2362.
[8] 方仲毅, 范帅, 徐丽丽, 等. 软组织牵伸配合物理因子改善第3磨牙拔除后的开口受限及下颌功能[J]. 中国组织工程研究,2015,19(2):252-256.
[9] Schiffman E, Ohrbach R, Truelove E, et al.Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group[J]. J Oral Facial Pain Headache,2014, 28(1):6-27.
[10] Stubblefield MD, Manfield L, Riedel ER.A preliminary report on the efficacy of a dynamic jaw opening device (dynasplint trismus system) as part of the multimodal treatment of trismus in patients with head and neck cancer[J]. Arch Phys Med Rehabil, 2010, 91(8):1278-1282.
[11] Xu L, He Y, Fan S, et al.Validation of a Chinese version of the jaw functional limitation scale in relation to the diagnostic subgroup of temporomandibular disorders[J]. J Oral Rehabil, 2020,47(1):1-8.
[12] Ohrbach R, Larsson P, List T.The jaw functional limitation scale: development, reliability, and validity of 8-item and 20-item versions[J]. J Orofac Pain,2008,22(3):219-230.
[13] Zhang Q, Yuan S, Deng K, et al.Correlation of patients' demographics and clinical symptoms with temporomandibular disorders[J]. Cranio, 2020,22(1):1-8.
[14] 孙守福, 张善勇, 杨驰. 颞下颌关节盘锚固术应用进展[J]. 中国口腔颌面外科杂志,2016, 14(2):179-182.
[15] Li XY, Jia C, Zhang ZC.The normal range of maximum mouth opening and its correlation with height or weight in the young adult Chinese population[J]. Dent Sci, 2017, 12(1):56-59.
[16] Bengtsson M, Fransson P.Do patient-reported outcome measures correlate with clinical follow-up after arthroscopic treatment of internal derangement of the temporomandibular joint?[J]. J Stomatol Oral Maxillofac Surg, 2021, 9(1):1-23.
[17] O'Donnell K, Freedman KB, Tjoumakaris FP. Rehabilitation protocols after isolated meniscal repair: a systematic review[J]. Am J Sports Med, 2017,45(7):1687-1697.
[18] Chang KV, Hung CY, Han DS, et al.Early versus delayed passive range of motion exercise for arthroscopic rotator cuff repair: a meta-analysis of randomized controlled trials[J]. Am J Sports Med, 2015,43(5):1265-1273.
[19] Abboud WA, Yarom N, Yahalom R, et al.Comparison of two physiotherapy programmes for rehabilitation after temporomandibular joint arthroscopy[J]. Int J Oral Maxillofac Surg, 2018,47(6):755-761.
[20] 张玲, 蔡斌, 范帅. 肘关节僵硬的牵伸支具治疗进展[J].中国康复医学杂志,2020,35(11):1397-1402
[21] Wang TJ, Su JH, Leung KW, et al.Effects of a mouth-opening intervention with remote support on adherence, the maximum interincisal opening, and mandibular function of postoperative oral cancer patients: A randomized clinical trial[J]. Eur J Oncol Nursing, 2019,40:111-119.

牵伸支具对颞下颌关节盘锚固术后患者开口受限的作用评价

Effect of stretching devices on mouth opening limitation in patients after temporomandibular joint disc anchoring

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