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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

24卷

期数:

2018年02期

页码:

170-173

栏目:

出版日期:

2018-03-20

文章信息/Info

Title:

CBCT study on temporomandibular joint structure of temporomandibular joint osteoarthritis in adult high-angle Class II malocclusion

作者:

王兰如; 李洪发; 李婵

天津医科大学口腔医院正畸科，天津 300070

Author(s):

WANG Lan-ru;  LI Hong-fa;  LI Chan

Department of Orthodontics , Stomatological Hospital, Tianjin Medical University, Tianjin 300070, China

关键词:

骨性Ⅱ类高角 ; 颞下颌关节骨关节病;  成人; 锥形束CT

Keywords:

high-angle Class II malocclusion;  temporomandibular joint osteoarthritis;  adult;  cone beam CT

分类号:

R783.5

DOI:

-

文献标志码:

A

摘要:

目的：研究成人骨性Ⅱ类高角型颞下颌关节骨关节病的关节结构特征，为正畸临床评估颞下颌 关节提供理论依据。方法：从成人颞下颌关节正常及成人骨性Ⅱ类高角颞下颌关节骨关节病锥形束CT （ CBCT）资料中各选取20例，将研究对象分2组，采用Invivo5 软件将CBCT 扫描数据进行三维重建，分别 测量关节窝、关节间隙、髁突等关节结构。结果：同颞下颌关节正常组相比，20例成人骨性II类高角颞 下颌关节骨关节CBCT样本中，关节窝前后径显著增加、高度显著减低（P＜0.01）；关节窝顶骨质显著增 厚（P＜0.01）；关节结节高度降低、后斜面角减小（P＜0.05)；矢状向关节后间隙减小，而关节上间隙 及前间隙都增加（P＜0.05）；髁突前后径、高度减小（P＜0.05）；水平角、髁突前斜面宽度及后斜面 角增加（P＜0.05）。结论：成人骨性Ⅱ类高角型颞下颌关节骨关节病在关节窝改变最明显，其次是关节 间隙和髁突的改变。

Abstract:

Objective: To study the characteristics of temporomandibularjoint osteoarthritis(TMJOA) by comparing TMJ structures in adult high-angle Class II malocclusion TMJOA group and normal TMJ group via cone-beam CT (CBCT) and Invivo5 software, so as to provide reference for clinical diagnosis. Methods: Twenty patients with normal TMJ and 20 patients with bilateral TMJOA and high-angle Class II malocclusion were selected. Invivo5 software was used to rebuild 3D image data and to measure glenoid fossa， condyle，joint space and position. Results: Compared with the control group, some bony changes were found in 20 adult high-angle Class II malocclusion TMJOA group, and the shape of the glenoid fossa became wider and shallower （P＜0.01）. However, the wall of the glenoid fossa roof was thickener （P＜0.01）. The height of the TMJ articular tubercle decreased and the slope became more flat（P＜0.05）. The posterior joint space gap was reduced, whereas the upper space and the anterior space increased in the sagittal direction（P＜0.05）. Condylar height decreased, however, the width of sagittal condylar forward slope increased（P＜0.05 ）, horizontal transverse condylar angle increased（P＜0.05）. Conclusion：The TMJOA in adult patients with skeletal Class II high angle glenoid fossa changes most significantly, followed by the joint space and condylar changes. CBCT and Invivo5 are practical tools for evaluation of TMJ , which can provide clinical reference and guidance for clinical orthodontic treatment

参考文献/References:

[1] Zarb G A, Carlsson G E. Temporomandibular disorders: osteoarthritis[J]. J Orofac Pain， 1999，13（4）:295
[2] Krisjane Z, Urtane I, Krumina G, et al. The prevalence of TMJ osteoarthritis in asymptomatic patients with dentofacial deformities: a cone-beam CT study[J]. Int J Oral Maxillofac Surg, 2012, 41(6):690
[3] Chen S, Lei J, Fu K, et al. Cephalometric analysis of the facial skeletal morphology of female patients exhibiting skeletal class II deformity with and without temporomandibular joint osteoarthrosis[J]. PLoS One, 2015 , 10(10):e0139743
[4] 姚霜, 刘晓君, 柴汝昌 ，等.不同垂直骨面型成人安Ⅱ患者颞下颌关节的形态特征研究[J]. 口 腔医学研究, 2012,28(1)：47
[5] Marques A P，Perrella A, Arita E S，et al. Assessment of simulated mandibular condyle bone lesions by cone beam computed tomography[J]. Braz Oral Res , 2010, 24(4):467
[6] Kikuchi K, Takeuchi S, Tanaka E, et al. Association between condylar position, joint morphology and craniofacial morphology in orthodontic patients without temporomandibular joint disorders[J]. J Oral Rehabil, 2003,30(11):1070
[7] Tsiklakis K. Radiographic examination of the temporomandibular joint using cone beam computed tomography[J]. Dentomaxillofac Radiol, 2014, 33:196
[8] Alexiou K E. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography[J]. Dentomaxillofac Radiol , 2014,38:141
[9] Ejima K. Relationship between the thickness of the roof of glenoid fossa, condyle morphology and remaining teeth in asymptomatic European patients based on cone beam CT data sets[J]. Dentomaxillofac Radiol , 2014, 42: 9092
[10] Katzberg R W, Keith D A, Guralnick W C, et al. Internal derangements and arthritis of the temporomandibular joint[J]. Radiology, 1983, 146(1):107
[11] 白果，何冬梅, 杨驰， 等. 颞下颌关节骨性三维测量标准的建立及在骨关节病中的应用[J]. 中 国口腔颌面外科杂志, 2016，14（1）:14
[12] Dias I M, Cordeiro P C, Devito K L，et al. Evaluation of temporomandibular joint disc displacement as a risk factor for osteoarthrosis[J]. Int J Oral Maxillofac Surg, 2016, 45(3):313
[13] Dias I M, Coelho P R, Picorelli Assis N M， et al. Evaluation of the correlation between disc displacements and degenerative bone changes of the temporomandibular joint by means of magnetic resonance images[J]. Int J Oral Maxillofac Surg, 2012, 41(9):1051
[14] Cho B H， Jung Y H. Osteoarthritis changes and condylar positioning of the temporomandibular joint in Korean children and adolescents[J]. Imaging Sci Dent, 2012，42（ 3）：169
[15] 刘展, 钱英莉, 张远理, 等. 关节盘移位对颞下颌关节内应力分布的影响[J]. 医用生物力学, 2013,28(5):528
[16] Lim M J, Lee J Y. Computed tomographic study of the patterns of oesteoarthritic change which occur on the mandibular condyle[J]. J Craniomaxillofac Surg, 2014,42(8):1897
[17] Cevidanes L H, Gomes L R, Jung B T, et al. 3D superimposition and understanding temporomandibular joint arthritis[J]. Orthod Craniofac Res, 2015,18(Suppl 1):18
[18] Kurita H, Koike T, Narikawa J, et al . Relationship between alteration of horizontal size and bony morphological change in the mandibular condyle[J]. Dentomaxillofac Radiol, 2003,32(6):355
[19] Lee P P. Greater mandibular horizontal condylar angle is associated with temporomandibular joint osteoarthritis[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2017,123(4):502

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备注/Memo

备注/Memo:

文章编号 １００６－８１４７（２０18）０2-0170-05
作者简介 王兰如（1990-），女，硕士在读，研究方向：主要从事正畸临床CBCT研究；通信作者：李洪发，E-mail：leehongfa@aliyun.com。

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更新日期/Last Update: 2018-03-20