顎関節内障クローズドロック症例に対する関節洗浄マニピュレーション法の効果

概要

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Fifteen closed lock cases (fifteen joints) of internal derangement of the temporomandibular joint (TMJ) were treated by lavage manipulation technique. This technique involves manipulation after irrigation of the upper compartment of the affected TMJ with 200-400 ml lactated Ringer's solution followed by an injection of sodium hyaluronate (SPH) into the upper compartment.<BR>In our case study, 11 of the 15 cases (73%) satisfied our criteria for successful treatment. MR imaging showed that only 2 (18%) of the 11 successful cases achieved complete reduction of the disk. In the remaining 9 cases, a significant range of mandibular motion was obtained by the condylar head sliding down under the anteriorly displaced disk during maximal mouth opening.<BR>This technique was highly effective in relieving pain, as well as improving limited mouth opening. By this technique we were able to release a closed lock case which could not be opened by the pumping manipulation technique. These results suggest that the lavage manipulation technique is a more useful form of nonsurgical treatment than the pumping manipulation technique for releasing closed lock disturbances in outpatients without hospitalization.
社団法人日本口腔外科学会の論文