Curative Effect Analysis Of Different Postoperative Adjuvant Therapies For Temporomandibular Joint Osteoarthrosis

Objective: This study aims to evaluate the clinical effect of different adjuvant treatments for temporomandibular joint osteoarthrosis(TMJOA).Methods: This study enrolled patients with TMJOA who mainly accepted temporomandibular joint disc repositioning and fixation routine temporomandibular joint surgery in our hospital,and patients with rheumatism,rheumatoid diseases and severe mental and psychological disorders were excluded.This was a retrospective study conducted from June 2015 to December 2017,a total of 64 cases of TMJOA in our hospital including 3 male cases and 61 female cases,aged from 30 to 67,with an average age of 56.0 ± 6.3 years were retrospectively analyzed.Clinical and imaging examinations were used to determine the pathological changes of the patients.Patients were randomly divided into three groups according to the different adjuvant treatment methods.In group A,22 cases were treated with splint and routine functional training;in group B,17 cases were treated with intraarticular injection of chitosan and routine functional training;in control group,25 cases only received routine functional training.We retrospectively analyzed the Fricton score of temporomandibular joint dysfunction index,the changes of mouth opening and the imaging examination for all the patients before,two weeks and three months after the operation,six months after which we reassessed indexes above for the patients in the group A and C.Results: 1.There was no significant difference in three groups before operation and 2 weeks after operation(P > 0.05),and the postoperative indexes in each group were significantly better than those before operation(P < 0.05)and MRI examination showed that the disc-condylar relationship was recovering well.2.Three months after operation: the VAS pain score,mandibular movement score,muscle tenderness index in group B < group A < group C,the differences among the three groups were statistically significant(P < 0.05).The index of temporomandibular dysfunction in group B < group A < group C,opening degree group B > group A > group C,respectively,the differences between group B and group A were statistically significant(P < 0.05)and there was no significant difference between group A and group C(P > 0.05).3.Around 6 months after operation,every index in group A was better than that in group C.There was no significant difference in opening degree between group A and group C(P > 0.05),and there were significant differences in other indexes(P < 0.05).Conclusions: Temporomandibular joint surgery can effectively treat TMJOA,relieve pain and increase mouth opening.Proper adjuvant treatments and functional training can significantly improve temporomandibular joint function after operation.The curative effect of intraarticular injection of chitosan was significantly better than that of the splint group and control group at three months after the operation,and the curative effect of the splint group was significantly better than that of the control group at six months after the operation.