无牙牙合患者修复前后双侧颞下颌关节盘-髁关系的初步分析  

Preliminary analysis of the bilateral disc-condyle relationship of TMJ before and after prosthetic rehabilitation in edentulous patients

作　　者：凌月华[1] 石慧敏[2] 赵军[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院.口腔医学院口腔修复科上海市口腔医学重点实验室,上海200011 [2]上海交通大学医学院附属第九人民医院放射科,上海200011

出　　处：《上海口腔医学》2011年第5期522-526,共5页Shanghai Journal of Stomatology

基　　金：上海市科学技术委员会资助项目(08DZ2271100)~~

摘　　要：目的:观察无颞下颌关节症状和体征的无牙颌患者修复前后双侧颞下颌关节(TMJ)盘-髁关系、关节腔积液及髁突骨质异常的变化。方法:通过8例无牙颌患者全口义齿修复前后双侧颞下颌关节的磁共振成像(MRI)检查,比较其修复前后双侧颞下颌关节MRI影像表现的差异。结果:修复前,8例无牙颌患者的16个关节中,10个关节盘移位(62.5%),包括7个关节盘内侧移位(43.8%),2个关节盘外侧移位(12.5%),1个关节盘前移位(6.25%);关节腔积液7个关节(43.8%);髁突骨质异常4个关节(25.0%)。修复后,8例无牙颌患者的16个关节中,10个关节盘移位(62.5%),包括7个关节盘内侧移位(43.8%)、2个关节盘外侧移位(其中1个关节盘外侧移位好转)和1个关节盘前移位(6.25%);关节腔积液7个关节(43.8%);髁突骨质异常4个关节(25.0%)。除1个关节的积液增加外,其余关节积液无变化。结论:长期缺牙可能引起无牙颌患者颞下颌关节的结构紊乱。无牙颌患者全口义齿修复后近期,关节盘移位、关节腔积液及髁突骨质异常无明显改变。PURPOSE： To observe the disc-condyle relationship,joint effusion,and osseous abnormalities of the condyle before and after prosthetic rehabilitation in 8 edentulous patients with asymptomatic of bilateral temporomandibular joints（TMJs）.METHODS： Complete dentures of 8 edentulous patients were made.Bilateral TMJ MRI before and after prosthetic rehabilitation was performed to observe TMJ internal changes.RESULTS：Before prosthetic rehabilitation,10 joint disc displacements were found in 62.5% of 16 TMJs of 8 edentulous patients,including 7 medial disc displacement,2 lateral disc displacement and anterior disc displacement（6.25%）;7 TMJs had effusion 4 had condylar abnormalities.After prosthetic rehabilitation,10 disc displacements were found in 16 TMJs of 8 edentulous patients,including 7 medial disc displacement,2 lateral disc displacement,and 1 anterior disc displacement;7 TMJs effusion.4 TMJs had condylar abnormalities.CONCLUSIONS： Long-time tooth loss may lead to internal derangement of TMJ in edentulous patients.In short term after prosthetic rehabilitation with complete denture,there is no distinct change in disc-condylar relationship,joint effusion,and condylar abnormalities in edentulous patients.

关 键 词：无牙颌 关节盘移位 颞下颌关节 磁共振成像 颞下颌关节紊乱 全口义齿 

分 类 号：R782.6[医药卫生—口腔医学]