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目的 :探讨颞下颌关节盘复位固定术后患者错的发生情况及术后咬合治疗的必要性。方法 :对2010年10月—2015年10月来无锡市人民医院口腔颌面外科就诊的颞下颌关节不可复性盘前移位行手术治疗的患者108例,术前记录咬合关系,术后辅助垫或固定矫正治疗,定期随访,评价咬合关系及关节盘-髁突的相对位置关系。结果:全部颞下颌关节盘复位固定术后患者均出现患侧后牙开、中线偏向对侧情况,戴用垫3~6个月后,后牙开情况改善,针对有牙列拥挤、上前牙舌倾等情况的患者应用固定矫治器治疗,术后长期随访患者关节盘-髁关系良好。结论:颞下颌关节盘复位固定术后患者常出现后牙开,可使用功能矫正器进行治疗,而后视具体错畸形情况进行固定矫治器治疗。
Objective: To investigate the incidence of misdiagnosis in patients after temporomandibular joint disc reduction and fixation and the necessity of postoperative bite therapy. Methods: From October 2010 to October 2015 in Wuxi City People’s Hospital Oral and Maxillofacial Surgery treatment of temporomandibular joint irreversible disc surgery in patients with 108 cases of preoperative record of occlusion, postoperative assistance pad or fixed orthodontic treatment, regular follow-up, evaluation of occlusal relationship and the relative position of the disc - condyle. Results: All the patients underwent TMJ disc herniation and the midline skewed to the contralateral side. After 3 to 6 months of wearing the cerclage pad, the opening of the posterior teeth was improved. For patients with dentition crowding , The situation such as tilt teeth before the application of fixed appliance treatment, long-term follow-up of patients with articular disc - condyles good relationship. CONCLUSIONS: Temporomandibular joint disc fixation and fixation patients often have open posterior teeth that can be treated with functional orthosis, and then treated with fixed appliance according to the specific malocclusion.