三维重建分析安氏Ⅱ类亚类偏颌矫治前后颞下颌关节及下颌骨形态的改变  

Morphological changes of mandible and temporomandibular joint in mandibular asymmetry patients with class Ⅱ subdivision malocclusion before and after orthodontic treatment by three-dimensional reconstruction

作　　者：唐玉娟[1] 王超[1] 陈杨[1] 秦朴[1] 

机构地区：[1]重庆医科大学附属口腔医院正畸科、口腔疾病与生物医学重庆市重点实验室、重庆市高校市级口腔生物医学工程重点实验室,重庆401147

出　　处：《第三军医大学学报》2016年第10期1139-1143,共5页Journal of Third Military Medical University

基　　金：重庆市卫生局医学科研面上项目(2012-1-055,2012-2-128)~~

摘　　要：目的通过锥形束CT(cone-beam computerized tomography,CBCT)分析安氏Ⅱ类亚类偏颌畸形患者正畸治疗前后颞下颌关节及下颌骨的形态特征。方法对60例生长发育高峰期及高峰期后的安氏Ⅱ类亚类偏颌畸形患者正畸治疗前后使用CBCT采集颅面Dicom数据,使用Mimics 15.0对骨组织进行三维重建,并建立三维坐标系。选择描述下颌骨、髁突及关节窝的11对测量项目进行统计分析。结果生长发育高峰期的安氏Ⅱ类亚类偏颌畸形患者正畸治疗前后中性侧与远中侧的下颌骨、髁突及关节窝形态无明显差异;生长发育高峰期后的患者治疗前中性侧的下颌支长度、髁突全高及关节窝前部宽度明显大于远中侧(P<0.05),而治疗后只有中性侧的关节窝前部宽度大于远中侧(P=0.023)。结论安氏Ⅱ类亚类偏颌畸形是有功能性下颌偏斜向骨性偏斜发展,而在生长发育高峰期对其进行治疗,有利于减少后期的骨性畸形。Objective To analyze the morphological characters of mandible and temporomandibular joint in mandibular asymmetry patients with class Ⅱ subdivision malocclusion before and after orthodontic treatment by cone-beam computed tomography（ CBCT）. Methods For 60 mandibular asymmetry patients with class Ⅱ subdivision malocclusion,who were at the pubertal stage or after the pubertal stage,CT images were reconstructed into 3D models by Mimics 15. 0 and 3D coordinate system was set up. Anatomical landmarks of mandible,condyle and glenoid fossa were located and established reference planes. Eleven sets of measurements from anatomical landmarks of mandible,condyle and glenoid fossa were used for statistical analysis. Results The morphology of mandible,condyle and glenoid fossa at class Ⅰ side and class Ⅱ side in mandibular asymmetry patients with class Ⅱ subdivision malocclusions at the pubertal stage had no difference before and after orthodontic treatment. The length of mandibular rumus,condylar height and anterior fossa width at class Ⅰ side of patients after the pubertal stage were significantly larger than those at class Ⅱ side before orthodontic treatment（ P〈 0. 05）. But after treatment,only the anterior fossa width at class Ⅰ side was longer than that at class Ⅱ side（ P = 0. 023）. Conclusion Mandibular asymmetry of patients with class Ⅱ subdivision malocclusions is developed from functional mandibular deviation to skeletal deviation,and treatment at the pubertal stage is beneficial to reduce the deformity at the late stage.

关 键 词：安氏Ⅱ类亚类 下颌骨偏斜 三维测量 锥形束CT 正畸治疗 

分 类 号：R783.5[医药卫生—口腔医学]