目的：比较咀嚼肌功能锻炼和超短波理疗治疗颞下颌关节弹响的效果。探讨颞下颌关节弹响发生的可能机制。方法：选择128例弹响患者，随机分为实验组和对照组，每组64例。实验组行咀嚼肌功能锻炼，对照组行超短波理疗，疗程两周，随访3个月。比较两种方法的治疗效果。结果：2周后，实验组的64例患者弹响全部消失，总有效率100%；对照组的64例患者33例弹响消失，20例弹响次数减少，11例弹响次数无改变，总有效率82.81%，两组结果有显著性差异(P < 0.05)，3个月后，治疗组随访率95.31%，对照组随访率93.75%，治疗组总有效率100%，对照组总有效率66.67%，两组结果有显著性差异(P < 0.05)，3月后对照组治疗总有效率下降(P < 0.05)。结论：咀嚼肌功能锻炼治疗颞下颌关节弹响的效果优于超短波理疗，咀嚼肌功能锻炼治疗颞下颌关节弹响的疗效显著。
Objective: To compare the clinical therapeutic efficacy of masticatory muscles functional exercise and ultra-short wave therapy, and investigate a possible pathological mechanism about articulation mandibularis clicking. Methods: 128 patients with articulation mandibularis clicking were selected and divided into two groups (experimental group and control group) of 64 patients each randomly. Patients in experimental group were taught to do masticatory muscles functional exercise for 2 weeks. Patients in control group were treated with ultra-short wave therapy for 2 weeks and 3-month follow-up. The therapeutic effects of the two methods were compared. Results: After 2 weeks, symptoms of articulation mandibularis clicking disappeared in 64 patients of experimental group and 33 patients of control group; the total effective rate was 100%; 20 patients in control group showed improvement of their symptoms and 11 patients in control showed no improvement. The total effective rate was 82.81%. There were significant differences between the two groups (P < 0.05). After 3 months, the follow-up rate of the treatment group and the control group was 95.31% and 93.75%, respectively; the total effective rate of treatment group and the control group was 100% and 66.67%, respectively. There were significant differences between the two groups (P < 0.05), and we could see lower therapeutic effect in control group after 3 months (P < 0.05). Conclusions: Masticatory muscles functional exercise could cure articulation mandibularis clicking effectively and it’s a more effective way when compared with ultra-short wave therapy.
Katzberg, R.W., Dolwick, M.F., Bales, D.J., et al. (1979) Arthrotomography of the Temporomandibular Joint: New Technique and Preliminary Observations. American Journal of Roentgenology, 132, 949-955.
Manfredini, D. and Guarda-Nardini, L. (2008) Agreement between Research Diagnostic Criteria for Temporomandibular Disorders and Magnetic Resonance Diagnoses of Temporomandibular Disc Displacement in a Patient Population. International Journal of Oral and Maxillofacial Surgery, 37, 612-616. http://dx.doi.org/10.1016/j.ijom.2008.04.003