关键词: 颞下颌关节紊乱病, 关节盘不可复性前移位, 治疗策略, 咬合板, 手法复位

Abstract: Objective To explore the understanding of conservative treatment and the choice of treatment strategies of acute anterior disc displacement without reduction. Methods Twenty patients of acute anterior disc displacement without reduction with limited opening from May, 2018 to May, 2020 in the Department of Temporomandibular Joint, Nanjing Stomatological Hospital Medical School of Nanjing University, were included in the study. All patients received mandibular manipulation followed by occlusal splint therapy. After 3 months, the joint disc reduction and maximum active mouth opening of all patients were evaluated. SPSS 24.0 was used to test and analyze the data. Results The maximum active mouth opening of 20 patients was significantly improved, increasing from (27.15±5.91) mm to (41.35±4.82) mm; after treatment, MRI showed 13 cases (65%) of joint disc reduction in 20 patients, and 7 cases (35%) still had displacement without reduction. The difference between the maximum active mouth opening and the reduction of the joint disc after 3 months of treatment was statistically significant. Conclusion Mandibular manipulation combined with stabilization splint treatment of acute anterior disc displacement without reduction can effectively restore patients' mouth opening, improve joint function, and have a significant effect on the restoration of disccondyle relationship.

Key words: temporomandibular joint disorder, anterior disc displacement without reduction(ADDWoR), treatment strategy, splint, mandibular manipulation