Clinical Application Of Small Needle Knife Therapy In The Treatment Of Temporomandibular Joint Disc Displacement Without Reduction

Objective:To evaluate the clinical efficacy of small needle knife therapy combined with exercise therapy in the treatment of anterior disk displacement without reduction of temporomandibular joint.Methods:32 patients with anterior disk displacement without reduction were randomly divided into the experiment group(n=16)and the control group(n=16).both groups received health guidance,manual reduction,exercise training,and the experiment group was given small needle knife treatment at the same time.Visual analogue pain score(VAS),maximum mouth opening(MMO),Firction TMJ index of the two groups were compared and analyzed before treatment,3 months after treatment and 6 months after treatment.MRI examination was performed to observe the reduction of TMJ of the two groups.The measurement data were tested by SPSS19.0,and the results of MRI were tested by X~2.Results:The average maximum mouth opening(MMO)of the control group was 25.95 mm before treatment,increased to 38.71 mm after treatment,and the average maximum mouth opening was 38.94 mm and 38.94 mm at 3 and 6months of follow-up,respectively.The average maximum mouth opening(MMO)of the experiment group was 26.3 mm before treatment,increased to 41.06 mm after treatment,and was 41.044 mm and 41.19 mm at 3 and 6 months of follow-up,respectively.VAS score:16 patients in the control group decreased to 3.93 before treatment,1.60 after treatment,0.62 3months after treatment,1.18 and 0.62 6months after treatment,respectively,while 16 patients in the control group decreased to 0.063 before treatment,to0.375 and 0.25 3months after treatment and 6months after treatment.the Firction TMJ significantly improved at 3 months and 6 months after treatment,and the treatment effect was significantly different before,after treatment and between the two groups(p<0.05).MRI examination suggested both groups were diagnosed as anterior disc displacement without reduction before treatment.In the control group,3 months after treatment,6 of the 16 patients in were diagnosed as reducible anterior disc displacement,6months after treatment,3 patients relapsed into anterior disc displacement without reduction.In the experiment group,3 months after treatment 5 of the 16 patients in were diagnosed as reducible anterior disc displacement,6months after treatment,2patients relapsed into anterior disc displacement without reduction.The disc-condylar relationship of temporomandibular joint in the two groups was significantly improved by MRI compared with that before treatment(P>0.05).There was no significant difference in therapeutic effect between the two groups after treatment(P>0.05).Conclusion:Small needle knife combined with exercise therapy is more effective than simple exercise therapy in the treatment of irreversible anterior disc displacement of TMJ.