儿童功能性单侧后牙反患者的髁突对称性及矫治后髁突位置变化的研究  

Condylar asymmetry in children with functional unilateral posterior crossbite and changes in condylar position after treatment

作　　者：苏盈盈[1] 王春玲[1] 李红[1] 董仁萍[1] 

机构地区：[1]山东大学口腔医院正畸科,济南250012

出　　处：《口腔医学》2009年第6期305-308,共4页Stomatology

摘　　要：目的探讨儿童功能性单侧后牙反患者的髁突对称性及上颌扩弓治疗后髁突位置的变化。方法选择22例通过上颌扩弓成功矫治的功能性单侧后牙反儿童患者,男10例,女12例,年龄6.0-8.5岁,平均7.5岁作为实验组。另选择22例正常患者,男11例,女11例,年龄6.5-9.0岁,平均7.5岁作为对照组。反组矫治前后与对照组患者均拍摄曲面断层片和双侧闭口位矫正薛氏位片,测量髁突形态的不对称指数和髁突在关节窝中的相对位置。用SPSS 12.0软件进行统计分析。结果反组患者两侧髁突形态无明显不对称,与对照组相比,髁突高度(CH)、升支高度(RH)以及两者之和(CH+RH)的不对称指数均无统计学差异。反组矫治前(T1)两侧髁突在关节窝中的位置有明显差异,非反侧关节前间隙减小(P<0.05),上后间隙增大(P<0.05)。非反侧髁突在关节窝中的位置(R)相对反侧更加靠前(P<0.01)。矫治后(T2)双侧髁突位置变得相对对称。结论儿童功能性单侧后牙反患者的髁突形态相对对称,而髁突位置存在不对称性,说明下颌向反侧发生功能性偏斜,而这种偏斜并未导致髁突发生骨性不对称;正畸治疗可使两侧髁突位置更加协调。Objective To examine condylar asymmetry in children with functional unilateral posterior crossbite and to study the changes in condylar position after correction of the crossbite by maxillary expansion. Methods Twenty-two children aged from 6.0 to 8.5 years （ mean,7.5 years） with unilateral posterior crossbite were compared with 22 children aged from 6.5 to 9.0 years （ mean,7.5 years） with normal occlusion. Pretreatment panoramic radiographs were used to study condylar asymmetry and condylar asymmetry indices were analyzed. In addition, the anterior, superior, and posterior joint spaces were measured to determine differences of relative condylar position before and after crossbite correction with the use of TMJ transcranial lateral cephalometric radiographs. All data were ana- lyzed with SPSS 12.0 software. Results The patients with unilateral posterior crossbite had more asymmetrical condylar relationship. Compared with the controls, anterior joint space was smaller, whereas, upper and posterior spaces were greater on the noncrossbite side before treatment. Relative condylar position was more anterior on the noncrossbite side, compared with the crossbite before treatment, but similar on both sides after treatment. There were no statistically significant differences in condylar for the variables describing skeletal asymmetry of the condyles in crossbite group. Conclusion Children with unilateral posterior crossbite have asymmetrical relative condylar position, but they have symmetrical condylar shape. The correction of posterior crossbite results in a more symmetrical condylar position.

关 键 词：后牙反[牙合] 髁突 颞下颌关节 不对称 

分 类 号：R783.5[医药卫生—口腔医学]