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髁突特发性吸收(idiopathic condylar resorption,ICR)是一种罕见的以髁突骨吸收为主要临床表现的关节退行性病变,表现为以髁突骨关节面破坏为主的一系列炎症反应,严重影响口颌面美观及功能,是口腔临床治疗的难点和重点。文章从ICR的病因入手,探讨其可能的致病因素,并结合青少年进展期ICR的临床特点,深入阐述以关节腔注射-稳定性咬合板治疗-正畸治疗-关节盘复位术-下颌牵张成骨-正颌外科手术为主要治疗手段的多学科联合治疗。对于早期关节腔炎症反应明显、髁突形态未遭到严重破坏的患者,采取关节腔注射结合稳定性咬合板治疗的可逆性保守治疗;在上述治疗基础上,对于关节腔炎症反应基本得到控制、髁突骨皮质连续性逐渐恢复、髁突高度基本维持的患者,采取以MEAW技术髁突减压为代表的正畸非可逆性保守治疗;对于髁突形态遭到严重破坏的患者,采取牵张成骨术、正颌外科手术、全关节置换等方法恢复颜面美观及口颌面系统的正常生理功能。以期在该疾病的快速进展期,切实有效地控制关节腔的炎症反应,最大限度恢复髁突骨皮质的连续性,保留髁突的正常形态和功能,避免形成严重的骨性畸形。
Condylar idiopathic idiopathic condylar resorption (ICR) is a rare condylar bone resorption as the main clinical manifestations of degenerative joint degeneration, manifested as the destruction of the condylar articular surface of a series of inflammatory reactions, Seriously affect the mouth and face aesthetics and function, oral clinical treatment is the difficulty and focus. This article starts with the etiology of ICR and explores its possible causative factors. Combined with the clinical features of adolescent progression to ICR, this article describes in depth the treatment of joint-stability-occlusal plate-orthodontic treatment-disc replacement-mandibular distraction Orthopedic - orthognathic surgery as the main treatment of multidisciplinary combination therapy. For patients with early inflammatory reaction in the joint cavity and condyles whose morphology was not severely damaged, the patients received reversible conservative treatment with joint injection and stabilization bite plates. On the basis of the above treatment, the inflammation of joint cavity was basically controlled, Condylar bone cortical continuity gradually restored, the height of the condylar height was maintained in patients with MEAW technology to take the mandibular decompression as the representative of orthodontic non-reversible conservative treatment of condyle morphology was severely damaged patients to take distraction Osteogenesis, orthognathic surgery, total joint replacement and other methods to restore the beautiful facial and oral and maxillofacial system of normal physiological function. With a view to effectively controlling the inflammatory reaction of the joint cavity during the rapid progression of the disease, the continuity of the condyle cortical bone can be restored to the maximum extent, the normal condyle shape and function can be preserved, and the formation of serious bone deformity can be avoided.