摘要：

目的：探讨数字化辅助稳定咬合导板治疗颞下颌关节紊乱病（temporomandibular disorder，TMD）的临床效果。方法：选择2019年6月—2020年6月间绵阳市中心医院口腔门诊接诊的90例TMD患者，采用随机数字表法将患者分为数字化组和常规组，每组各45例。数字化组采用数字化取模和𬌗板设计制作咬合导板，常规组采用硅橡胶取模，超硬石膏灌制𬌗板，并重衬𬌗托咬合面，设计制作咬合导板。比较2组疗效、𬌗板制作口内操作时间、咬合导板制作时间、疼痛程度、主动最大开口度、颞下颌关节紊乱指数（Fricton指数）及患者佩戴满意度。结果：数字化组治疗6个月后的有效率高于常规组（P<0.05），分别为88.89%和71.11%；数字化组𬌗板制作口内操作时间、咬合导板制作时间均小于常规组（P<0.001）；数字化组治疗第7周、第10周视觉模拟评分法（visual analogue scale，VAS）评分，Fricton指数均低于常规组（P<0.05），主动最大开口度大于常规组（P<0.05）；数字化组佩戴满意度高于常规组（P<0.05），分别为93.33%和73.33%。结论：数字化辅助稳定咬合导板治疗TMD可缩短口内操作时间和咬合导板制作时间，能更有效改善临床症状和颞下颌关节功能，患者满意度高。

关键词: 颞下颌关节紊乱病, 稳定咬合导板, 计算机, 口内扫描, 数字化设计

Abstract:

Objective: To investigate the clinical effects of digital-assisted stable occlusal plate in the treatment of temporomandibular disorder (TMD). Methods: A total of 90 patients with TMD admitted to the dental outpatient department of Mianyang Central Hospital from June 2019 to June 2020 were selected and equally divided into digitalized group(n=45) and conventional group(n=45) by random number tables method. The digitalized group adopted the digital scanning impression and the occlusal plate designed to make the occlusal guide plate, while the conventional group adopted the silicone rubber mold and the occlusal plate was made by super anhydrite pouring. The therapeutic effect, intraoral operation time of occlusal plate fabrication, production time of occlusal guide plate, pain degree, active maximum opening degree, temporomandibular disorder index(Fricton index) and wearing satisfaction of patients were compared between the two groups. Results: After 6 months of treatment, the effective rate of the digitalized group was 88.89%, which was higher than that of the conventional group (71.11%, P<0.05). The intraoral operation time of the occlusal plate and production time of occlusal guide plate in the digitalized group were less than those of the conventional group (P<0.001). At the 7th and 10th weeks of treatment, the visual analogue scale(VAS) score, Fricton index of the digitalized group were lower than those of the conventional group (P<0.05), and the active maximum opening degree of the digitalized group was higher than that of the conventional group(P<0.05). The satisfaction rate of the digitalized group was 93.33%, which was higher than that of the conventional group(73.33%, P<0.05). Conclusion: The digital-assisted stable occlusal plate in the treatment of TMD can shorten the time of intraoral operation and production occlusal guide plate, and improve the clinical symptoms and the function of temporomandibular joint (TMJ) more effectively with high patient satisfaction.

Key words: temporomandibular disorder, stable occlusal plate, computer, intraoral scanning, digital design

中图分类号: 

• R782