目的 评价关节冲洗结合稳定型咬合板治疗慢性不可复性关节盘前移位的临床效果及该疾病与心理因素的相关性。方法 收集河南省人民医院2021年12月-2023年6月确诊为颞下颌关节不可复性前移位患者，根据本实验纳排标准分成A组:关节冲洗30例;B组:关节冲洗+稳定型咬合板30例。分别记录术前、术后即刻、术后2周、1个月、3个月、6个月最大开口度、视觉疼痛模拟评分值(VAS)及治疗前后抑郁焦虑压力量表21项(Depression Anxiety and Stress Scale，DASS-21)。结果 B组最大开口度、VAS值降低程度在术后2周、术后1个月、3个月、6个月均优于A组且具有统计学差异(P＜0。05);与A组相比，B组开口度在术后2周效果更稳定(P＜0。05);A组与B组在术后DASS-21评分均较术前有明显改善(P＞0。05)。结论 关节冲洗结合稳定型咬合板治疗慢性不可复性颞下颌关节盘前移位效果更优异，临床可推广使用。慢性不可复性颞下颌关节盘前移位患者的心理情况(抑郁、焦虑、压力)与关节区不适症状具有一定相关性，临床治疗时可在同期行心理干预。
Observation on therapeutic effect of joint irrigation combined with stable occlusal plate on chronic irreversible anterior disc displacement of temporomandibular joint
Objective To evaluate the clinical efficacy of joint irrigation combined with stable occlusal plates in the treatment of chronic irreversible anterior disc displacement and the correlation between this disease and psychological factors.Methods Collected patients with irreducible anterior displacement of the temporomandibular joint diagnosed by Henan Provincial People's Hospital from December 2021 to June 2023,and divide them into Group A according to the inclusion and exclusion criteria of this experiment:30 cases with joint irrigation;Group B:30 cases with joint irrigation and stable bite plate.Record the maximum opening angle,visual pain simulation score(VAS),and 21 items of the De-pression Anxiety and Stress Scale(DASS-21)before and after treatment,immediately after surgery,2 weeks,1 month,3 months,and 6 months after surgery.Results The maximum opening degree and VAS value decrease in Group B were better than those in Group A at 2 weeks,1 month,3 months,and 6 months after surgery,with statistical differ-ences(P＜0.05);Compared with Group A,Group B had a more stable effect on opening degree at 2 weeks after sur-gery(P＜0.05);Both Group A and Group B showed significant improvement in DASS-21 scores after surgery com-pared to before(P＞0.05).Conclusion The combination of joint irrigation and stable occlusal plate has better thera-peutic effects on chronic irreversible anterior disc displacement of the temporomandibular joint,and can be widely used in clinical practice.The psychological status(depression,anxiety,stress)of patients with chronic irreducible anterior disc displacement of the temporomandibular joint is related to the discomfort symptoms in the joint area,and psychological in-tervention can be performed simultaneously during clinical treatment.
Anterior disc displacement with out reduction(ADDDoR)of the temporomandibular jointStable bite plateFlushing of the joint cavity
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