Redüksiyonsuz Disk Deplasmanı Olan Hastalarda Stabilizasyon Splinti ile ve Splintsiz Artrosentez Uygulamalarının Karşılaştırmalı Sonuçları

Öz

Amaç: Bu retrospektif çalışmanın amacı, redüksiyonsuz disk deplasmanı (RDD) tanısı alan hastalarda artrosentezin tek başına uygulanması ve artrosentez ile birlikte stabilizasyon splint (SS) tedavisi kombinasyonunun uzun dönem etkinliğini karşılaştırmaktır. Gereç ve Yöntemler: 2018–2022 yılları arasında tedavi edilen 49 hastaya (57 TMJ) ait tıbbi kayıtlar retrospektif olarak incelendi. Hastalar sadece artrosentez uygulananlar (AO, n=26) ve artrosentezle birlikte stabilizasyon splinti uygulananlar (A+SS, n=23) olmak üzere iki gruba ayrıldı. Ağrı şiddeti görsel analog skala (pVAS) ile, maksimum interinsizal açıklık (MIA) ise tedavi öncesi (T0), 1 ay (T1) ve 12 ay (T2) sonrası ölçüldü. Grup içi ve gruplar arası karşılaştırmalar, veri dağılımına uygun istatistiksel testlerle yapıldı. Bulgular: Her iki grupta da zaman içinde pVAS ve MIA değerlerinde anlamlı iyileşmeler gözlendi (p<0.001). T1’de, AO grubunda ağrı düzeyinde daha fazla azalma görülürken (p<0.05), A+SS grubunda MIA artışı daha belirgindi (p<0.05). Ancak T2 zaman noktasında, her iki parametre açısından gruplar arasında anlamlı fark bulunmadı (p>0.05). Sonuç: Artrosentezin tek başına uygulanması ve artrosentezin stabilizasyon splinti ile birlikte uygulanması, RDD hastalarında benzer uzun dönem sonuçlar sağlamaktadır. Kombine tedavi kısa vadede fonksiyonel faydalar sunsa da, bu avantajlar 1 yıllık takipte kalıcı olmamıştır. Sadece artrosentez, RDD tedavisinde pratik ve etkili bir tedavi seçeneği olarak değerlendirilebilir.

Anahtar Kelimeler

• Artralji
• Eklem hastalıkları
• Oklüzal splintler
• Temporomandibuler eklem

Comparative Outcomes of Arthrocentesis with and without Stabilization Splints in Patients with Disc Displacement without Reduction

Öz

Objective: This retrospective study aimed to compare the longterm effectiveness of arthrocentesis alone versus arthrocentesis combined with stabilization splint (SS) therapy in patients diagnosed with disc displacement without reduction (DDwoR). Materials and Methods: Medical records of 49 patients (57 TMJs) treated between 2018 and 2022 were retrospectively analyzed. Patients were divided into two groups: those who received arthrocentesis only (AO, n=26) and those who received arthrocentesis combined with a stabilization splint (A+SS, n=23). Pain intensity was evaluated using a visual analogue scale (pVAS), and maximum interincisal opening (MIO) was measured at baseline (T0), 1 month (T1), and 12 months (T2) post-treatment. Intragroup and intergroup comparisons were performed using appropriate statistical tests based on data distribution. Results: Both groups showed significant improvements in pVAS and MIO over time (p<0.001). At T1, the AO group demonstrated greater pain reduction (p<0.05), while the A+SS group showed greater MIO improvement (p<0.05). However, no significant differences were observed between groups at T2 for either parameter (p>0.05). Conclusion: Arthrocentesis alone and in combination with a stabilization splint provided similar long-term outcomes in patients with DDwoR. Although the combined therapy yielded early functional benefits, these advantages were not sustained at the 1-year follow-up. Arthrocentesis appears to be a practical and effective standalone treatment option for DDwoR.

Anahtar Kelimeler

• Arthralgia
• Joint disorders
• Occlusal splints
• Temporomandibular joint

Kaynakça

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