| Objective:Our study aims to evaluate the effect of different bone marrow characteristics on stable occlusal plate in osteoarthritis of temporomandibular joint(TMJ),so as to explore the prognostic reference of temporomandibular joint osteoarthritis in adolescents,and to find appropriate treatment measures for different types of condylar bone marrow.Methods:Thirty patients with TMJ osteoarthritis diagnosed by MR and CBCT were selected.Perfusion parameters were obtained by DCE-MRI,and the normal reference range of perfusion parameters was obtained based on the statistics of healthy volunteers.Patients were divided into three groups(edema group,sclerosis group and normal group).After 6 months of stable occlusal splint treatment,RVU was recorded before and after treatment to evaluate the degree of pain improvement,bone marrow perfusion parameters were recorded before and after treatment to evaluate the characteristics of blood perfusion,bone destruction parameters were recorded before and after treatment.Differences between the three groups analysis using ANOVA test,two compared the LSD-t test,edema and hardening group before and after the treatment the comparison of perfusion parameters paired t test,bone damage parameter set of comparison before and after the treatment using Wilcoxon rank test,hardening bone damage parameter set of comparison before and after the treatment with paired t test,define the inspection level is 0.05,P<0.05,the difference was statistically significant.Results:1.According to the statistics of perfusion parameters of healthy volunteers,the normal reference ranges were Ktrans: 0.62～0.85;Kep: 0.63～0.79;Ve: 0.68～0.76.2.Ktrans of the bone marrow edema group before and after treatment were 1.23±0.24,0.80±0.09,respectively.It was statistically significant(P<0.05);Kep was 1.03±0.18,0.76±0.08,respectively,and the difference was statistically significant(P<0.05);Ve was 0.84±0.06,0.79±0.03,respectively,and the difference was statistically significant(P <0.05).The Ktrans of the bone marrow sclerosis group before and after treatment were 0.36±0.12,0.41±0.04,the difference was not statistically significant(P>0.05);Kep was 0.39±0.10,0.42±0.11,the difference was not statistically significant(P>0.05);Ve was 0.60±0.04 and 0.56±0.07,respectively,the difference was not statistically significant(P>0.05).3.After treatment,the RVU of the bone marrow edema group was-36.83±12.04,the RVU of the bone marrow sclerosis group was-20±8.34,and the normal bone marrow group was-33.92±11.88.The difference between the bone marrow edema group and the normal group and the bone marrow sclerosis group was statistically significant(P<0.05).There was no significant difference between the bone marrow edema group and the normal group(P>0.05).4.The bone destruction parameters of the bone marrow edema group before and after treatment were 3.25±0.87,3.08±0.79,and the difference was not statistically significant(P>0.05).The bone destruction parameters of the bone marrow sclerosis group before and after treatment were 3.25±0.87,3.08±0.79,respectively.The difference is not statistically significant(P>0.05).Conclusion:1.Stable bite splint therapy can significantly relieve pain symptoms for patients in the bone marrow edema group and the normal group,but it is not effective for patients in the bone marrow sclerosis group.2.The perfusion parameters of the bone marrow edema group were significantly improved before and after treatment,suggesting that the stable bite splint treatment can help correct the pathological state of bone marrow edema.However,the abnormal improvement of perfusion parameters in the bone marrow sclerosis group was not obvious.It is suggested that patients with bone marrow sclerosis in clinical practice may need to combine other treatment measures such as drugs and surgery,rather than simple stabilization splint therapy. |
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