Abstract:

Objective　To analyze the value of manual reduction combined with stable occlusal plate in the treatment of temporomandibular disorders (TMD). Methods　A total of 200 patients with TMD admitted in Zhengzhou People's Hospital from August 2019 to February 2022 were selected as the study objects. According to the patients' intention, they were divided into a conventional group and a combined group. In the conventional group, there were 51 males and 47 females, aged (31.74±5.13) years; in the combined group, there were 64 males and 38 females, aged (30.65±5.28) years. The combined group was treated with manual reduction combined with stable occlusal plate, and the conventional group was treated with stable occlusal plate. The clinical efficacy, appearance satisfaction, pain degree [Visual Analogue Scale (VAS) score], temporomandibular joint opening index (TOI), Temporomandibular Joint Function Scale (Helkimo) score, surface electromyography (EMG) at rest [left anterior temporalis muscle (LTA), right anterior temporalis muscle (RTA), left masseter muscle (LMM), and right masseter muscle (RMM)] were compared between the two groups. t test and χ² test were used. Results　The total clinical effective rate [96.08% (98/102)] and overall appearance satisfaction rate [93.14% (95/102)] of the combined group were higher than those of the conventional group [82.65% (81/98) and 75.51% (74/98)] (χ²=9.586, P=0.002; χ²=11.857, P=0.001). After treatment, the VAS score [(2.09±0.45) points] and Helkimo score [(1.27±0.35) points] in the combined group were lower than those in the conventional group [(3.26±0.53) points and (2.04±0.33) points], and the TOI [(3.87±0.52) cm] was higher than that in the conventional group [(3.35±0.48) cm] (t=16.852, 15.944, and 7.341; all P<0.001). After treatment, the electromyography values of LTA [(2.31±0.33) μV], RTA [(2.18±0.36) μV], LMM [(1.37±0.24) μV], and RMM [(1.25±0.25) μV] in the combined group were lower than those in the conventional group [(2.87±0.35) μV, (2.79±0.38) μV, (1.68±0.23) μV, and (1.74±0.26) μV] (t=6.639, 6.646, 5.314, and 7.746; all P<0.001). Conclusion　Manual reduction combined with stable occlusal plate has a significant effect on TMD patients, which can relieve the spasm of masticatory muscles, restore the function of temporomandibular joint, relieve the patients' pain, improve the degree of mouth opening limitation, and improve the cosmetic effect.

Key words:

Temporomandibular disorders, Stable occlusal plate, Manual reduction, Surface electromyography, Cosmetic effect

摘要：

目的　分析手法复位联合稳定性咬合板在颞下颌关节紊乱病（TMD）患者治疗中的应用价值。方法　选取2019年8月至2022年2月郑州人民医院收治的200例TMD患者进行前瞻性研究，根据患者意愿分为常规组98例和联合组102例。常规组男51例、女47例，年龄（31.74±5.13）岁，实施稳定性咬合板治疗；联合组男64例、女38例，年龄（30.65±5.28）岁，实施手法复位联合稳定性咬合板治疗。比较两组临床疗效、外观满意度、疼痛程度［视觉模拟评分量表（VAS）评分］、颞下颌关节开口指数（TOI）、颞下颌关节功能量表（Helkimo）评分、静息状态下表面肌电图［左侧颞肌前束（LTA）、右侧颞肌前束（RTA）、左侧咬肌（LMM）、右侧咬肌（RMM）］。采用t检验、χ²检验。结果　联合组临床总有效率［96.08%（98/102）］、外观总满意率［93.14%（95/102）］高于常规组［82.65%（81/98）、75.51%（74/98）］（χ²=9.586、P=0.002，χ²=11.857、P=0.001）。治疗后联合组VAS评分［（2.09±0.45）分］、Helkimo评分［（1.27±0.35）分］均低于常规组［（3.26±0.53）分、（2.04±0.33）分］，TOI［（3.87±0.52）cm］高于常规组［（3.35±0.48）cm］（t=16.852、15.944、7.341，均P<0.001）。治疗后联合组LTA［（2.31±0.33）μV］、RTA［（2.18±0.36）μV］、LMM［（1.37±0.24）μV］、RMM肌电值［（1.25±0.25）μV］均低于常规组［（2.87±0.35）μV、（2.79±0.38）μV、（1.68±0.23）μV、（1.74±0.26）μV］（t=6.639、6.646、5.314、7.746，均P<0.001）。结论　手法复位联合稳定性咬合板治疗TMD患者效果显著，能缓解咀嚼肌痉挛，恢复颞下颌关节功能，减轻患者疼痛和改善张口受限程度，且能提高美容效果。

关键词:

颞下颌关节紊乱病, 稳定性咬合板, 手法复位, 表面肌电图, 美容效果