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目的:口内口外2种手法复位颞下颌关节急性前脱位的适应征及2者有无差异。方法:视颞下颌关节肿胀情况选择复位方法,肿胀较轻者采用口外手法复位,肿胀较重者因局部无法抓捏及按压后疼痛加重刺激肌肉收缩,影响复位,可采用口内手法复位。复位前均行颞下颌关节周围按摩3～5分钟,以松弛局部肌肉。复位后均采用绷带或颅颌弹力绷带固定于闭口位。总结8年来运用口内手法复位颞下颌关节急性前脱位病例,并与运用口外手法复位颞下颌关节脱位进行对比分析。结果:口内法复位成功率94.29%,口外法复位成功率94.12%,P>0.05。口内口外法手法复位无明显差异性,适应症选择正确临床均可采用。结论:口外法适用颞下颌关节肿胀较轻者及无牙颌磨牙缺失患者,复位效果很理想。口内法可以适用于颞下颌关节肿胀较重者及磨牙缺失少的患者急性前脱位复位,,临床上针对不同病例可采用口内及口外法手法复位。2种方法均取得满意的效果。
OBJECTIVE: To investigate the indications for the treatment of acute anterior dislocation of the temporomandibular joint and whether there is any difference between the two methods in 2 kinds of manipulation. Methods: Depending on the temporomandibular joint swelling, select the reset method, less swelling by mouth reduction, heavier swelling due to local non-grasping and post-press pain to stimulate muscle contraction, affecting the reduction, can be reset by mouth. Before reoperation, we performed massage around the temporomandibular joint for 3 ~ 5 minutes to relax the local muscles. After the reset are used bandage or craniomaxillary elastic bandage fixed in the mouth position. In the past 8 years, the cases of acute anterior dislocation of temporomandibular joint were reset by intraoral manipulation, and compared with the reduction of temporomandibular joint dislocation by mouth operation. Results: The success rate of reduction in oral cavity was 94.29%, and the success rate of reduction in oral cavity was 94.12% (P> 0.05). No significant difference in the reduction of intra-oral and extra-operative procedures, indications choose the correct clinical can be used. Conclusion: The extraoral method is suitable for the patients with less swelling of temporomandibular joint and the absence of maxillary maxillary molars. The reduction effect is ideal. Mouth method can be applied to patients with severe swelling of the temporomandibular joint and the lack of molars in patients with acute anterior dislocation reduction, clinically applicable to different cases of oral and oral manipulation reduction. 2 kinds of methods have achieved satisfactory results.