采用锥形束CT分析安氏Ⅱ类1分类错患者Twin-block矫治前后颞下颌关节的变化  

Cone-beam CT evaluation of the changes in the temporomandibular joint of patients with class Ⅱ division 1 subdivi- sion malocclusion before and after Twin-block treatment

作　　者：刘博文[1] 王艳民[1] 宋芳[1] 刘敏[1] 段莹[1] 周力[1] 

机构地区：[1]口腔疾病研究国家重点实验室华西口腔医院正畸科(四川大学),成都610041

出　　处：《华西口腔医学杂志》2013年第6期610-614,共5页West China Journal of Stomatology

基　　金：四川省科技厅科技支撑计划基金资助项目(2011FZ00-12;2008SZ0175);四川省卫生厅科研基金资助项目(090304)

摘　　要：目的运用锥形束CT(CBCT)分析安氏Ⅱ类1分类错在Twin-block矫治前后颞下颌关节位置及形态结构在三维方向上的变化。方法选取20例处于生长发育高峰前期或高峰期的安氏Ⅱ类1分类错患者,拍摄其功能矫治前后双侧颞下颌关节的CBCT片,运用InVivoDental软件对CBCT片进行三维重建并测量线距和角度,对测量结果进行统计学分析。结果与治疗前相比,治疗后矢状向关节前间隙减小,关节上间隙和后间隙增大,冠状向关节上间隙增大(P<0.01);髁突高度、矢状向髁突角度、横断面髁突前后径增加(P<0.01)。结论采用Twin-block矫治器治疗安氏Ⅱ类1分类错患者后,髁突在关节窝的位置和髁突部分骨性结构发生了一定程度的改变,髁突有新骨沉积,高度增加,在关节窝内的位置更向下和向前。CBCT的应用使颞下颌关节结构的变化得以量化,能对正畸治疗效果进行客观评价。Objective This study aims to evaluate the temporomandibular joint （TMJ） changes in patients with class Ⅱ division 1 subdivision malocclusions.before and after Twin-block treatment using a cone-beam CT （CBCT）. Methods Twenty subjects with class Ⅱ division 1 subdivision malocclusions were included in this study. Hand-wrist radiographs were conducted in the FG-G stage. CBCT was performed to determine the changes in the TMJ before and after the Twin-block treatment. The InVivoDental software was used to calculate the relevant parameters from the three-dimensional CBCT images. The acquired data were then analyzed. Results After treatment, the sagittal condylar anterior spaces were reduced, whereas the sagittal condylar superior and posterior spaces as well as the coronal condylar superior space increased （P〈0.01）. The condylar height, sagittal condylar angles, and condylar anteroposterior diameters also increased （P〈0.01）. Conclusion After the Twin-block treatment, new bone deposition was observed on the condyle. The condyle height also increased and resulted in adjustments in the condyle position within the glenoid fossa to more downward and forward positions. CBCT can quantify TMJ changes and provide an objective assessment to orthodontic treatment.

关 键 词：锥形束CT 安氏Ⅱ类1分类错胎 Twin—block功能矫治器 颞下颌关节 

分 类 号：R783.5[医药卫生—口腔医学]