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目的 :介绍一种缺牙伴颞下颌关节盘不可复性前移位的同期治疗方案。方法 :2013年7月—2014年10月,5例缺牙伴颞下颌关节紊乱患者,平均年龄41.8岁(28~51岁),术前经MRI检查确诊为颞下颌关节盘不可复性前移位,全景片、锥形束CT(CBCT)确定缺牙位置及缺牙区骨量,临床检查开口度均小于一指,关节区有明显疼痛。术前采用Simplant 11.04软件辅助设计种植体植入方案,并制作种植导板,术中关节盘锚固术和导板辅助一期牙种植手术先后进行,术后3个月行二期种植手术,半年后进行冠修复。结果:术后关节盘位置、开口度恢复良好,关节区无疼痛,缺牙区牙冠形态、咬合关系恢复良好。结论:对于期望种植修复牙列缺损但伴颞下颌关节盘不可复性前移位的患者,将关节盘锚固术和种植手术同期进行是一种可行的治疗方案。
OBJECTIVE: To introduce a simultaneous treatment of edentulous mandibular temporomandibular joint disc with refractory anterior displacement. Methods: From July 2013 to October 2014, 5 patients with missing teeth and temporomandibular joint disorder had an average age of 41.8 years (range, 28 to 51 years). Preoperative diagnosis of temporomandibular joint disc preoperatively could not be retrofitted Bone, panoramic film, conical beam CT (CBCT) to determine the location of missing teeth and bone loss in the periodontal area, the clinical examination of the opening degree of less than one finger, joint area obvious pain. Preoperative use of Simplant 11.04 software to aid the design of implant implantation program, and the production of planting guide plate, intraoperative arthroplasty and guide plate assisted dental implant surgery has been carried out after three months of line two implant surgery, six months after Crown repair. Results: The position and opening of the articular disc recovered well after operation. There was no pain in the joint area and the shape of the crown in the edentulous area. The occlusal relationship recovered well. CONCLUSIONS: It is a viable option for simultaneous resection and implantation of an arthroplasty for patients who are expected to have implants repaired for dentition defects but not displaced with temporomandibular joint discs.