Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Clinical Effect of Arthrocentesis for Patients with Disc Displacement without Reduction of Temporomandibular Joint : Report of Cases

측두하악관절의 비정복성 관절원판변위 환자에 대한 관절강 세정술의 임상효과 : 증례보고

  • Kim, Cheul (Department of Oral Medicine and Diagnosis & Research Institute of Oral Science, College of Dentistry, Kangnung National University) ;
  • Kim, Young-Jun (Department of Oral Medicine and Diagnosis & Research Institute of Oral Science, College of Dentistry, Kangnung National University)
  • 김철 (강릉대학교 치과대학 구강내과.진단학 교실 및 구강과학연구소) ;
  • 김영준 (강릉대학교 치과대학 구강내과.진단학 교실 및 구강과학연구소)
  • Published : 2006.06.30
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Abstract

The management of refractory pain and limitation of mouth opening in the temporomandibular joint (TMJ) is both challenging and controversial. Arthrocentesis is a simple technique and it can be used instead of more invasive surgical procedures for patients who failed to conventional conservative treatments. The patients in this case report had complained persistent severe pain and restricted mandibular movement of TMJ, although they had been treated with conservative therapy, e.g., stabilization splint therapy, behavioral therapy, physical therapy, pharmacological therapy. Therefore we employed arthrocentesis for these patients, and they showed significant reduction of pain and improvement of mandibular movement after repetitive arthrocentesis. We recommend arthrocentesis as an effective, minimally invasive technique for patients with continuing severe pain and restricted mobility in the TMJ that is unresponsive to conservative management.

관절강세정술은 통상의 보존적 치료법에 실패한 측두하악관절장애 환자에서 합병증의 위험성이 높은 침습적인 외과적 수술법에 대신하여 첫 번째로 고려될 수 있는 치료법이다. 본 증례의 환자들은 측두하악관절의 비정복성 관절원판변위로 진단되어 지속적인 교합안정장치치료, 행동요법치료, 물리치료, 약물치료 등의 보존적 치료에도 불구하고 심한 관절동통과 하악운동범위의 제한을 호소하였다. 따라서 보존적 치료법에 잘 반응하지 않는다고 판단하여 반복적인 관절강세정술을 시행하였고, 시술직후 유의한 동통감소, 하악운동범위의 개선과 함께 양호한 치료경과를 나타냈다. 관절강세정술은 최소의 침습성을 지니는 가장 보존적인 외과적 술식으로서 통법의 보존적 치료에 반응하지 않는 비정복성 관절원판변위 환자를 상기 증례와 같이 적절히 선택한다면 측두하악관절장애의 동통과 기능제한에 효과적인 보조적 치료법이라고 생각된다.

Keywords

References

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