双（牙合）垫矫治器治疗青少年安氏Ⅱ1错（牙合）患者颞下颌关节变化的初步研究  

Comparative study of TMJ for adolescent Angle Ⅱ1 patients before and after Twin-block treatment

作　　者：张亚梅[1] 雷勇华[1] 邹双双[1] 刘璐[1] 

机构地区：[1]中南大学湘雅医院口腔医学中心,长沙410008

出　　处：《中华口腔正畸学杂志》2016年第1期12-16,共5页Chinese Journal of Orthodontics

摘　　要：目的 运用锥形束CT（cone-beam computed tomography,CBCT）及Invivo5软件研究青少年安氏Ⅱ1错（牙合）患者在双（牙合）垫矫治器（Twin-block）矫治前后的颞下颌关节（Temporomandibular Joint,TMJ）骨性结构及其髁状突相对关节窝位置的变化,了解Twin-block矫治器对颞下颌关节结构形态的影响.方法 选取27例处于生长发育高峰期或高峰前期的下颌后缩型安氏Ⅱ1错（牙合）患者为研究对象.于Twin-block矫治前后拍摄CBCT,利用Invivo5软件进行三维重建后,进行各线距和角度的测量.对测量结果进行配对t检验.结果 双侧髁突前后径及髁突高度均增加,且治疗前后差异具有统计学意义（P＜0.01）.其余各关于髁突和关节窝形态的测量项目的差异无统计学意义（P＞0.05）.治疗前后各关节间隙的差异均无统计学意义（P＞0.05）.结论 Twin-block能刺激青少年安氏Ⅱ1错（牙合）患者髁突的改建,使其髁突前后径及高度增加,但对其关节窝的改建及髁突相对于关节窝的位置关系的影响尚不明确.Objective The aim of this study was to explore the changes of the skeletal structure of temporomandibular joint （TMJ） and the condyle-fossa relationships in teenage orthodontic patients with class Ⅱ1 malocclusions before and after twin-block treatment by using cone-beamcomputered temography （CBCT） and Anatomage Invivo5 software,thus further understand the twinblock treatment＆#39;s effects on morphology and structure of TMJ.Methods Twenty-seven class Ⅱ 1 malocclusions patients with mandibular retrusion were included in this study.They were at or just before the peak phase of pubertal growth,and were scanned by CBCT before and after the Twin-block treatment.The three-dimensional images were reconstructed with Anatomage Invivo5 software,and linear and angular parameters were measured.Paired t-test was used.Results Condylar anteriorposterior diameters and condyle height increased after treatment in both sides,and showed statistical significance （P〈0.01.No significant differences were found about morphology parameters of condyleand fossa （P〉0.05）,and about parameters of joint space（P〉0.05）.Conclusions Twin-block can stimulate condylar reconstruction by increasing condylar anterior-posterior diameters and condyle height in adolescent patients with class Ⅱ1 malocclusions.The changes of glenoid fossa of temporomandibular joint and the condyle-fossa relationships have no significant differences before and after Twin-block treatment.

关 键 词：颞下颌关节 安氏Ⅱ类1分类错(牙合)畸形 TWIN-BLOCK矫治器 

分 类 号：R783.5[医药卫生—口腔医学]