拔除伸长第三磨牙对颞下颌关节各间隙在CBCT上的测量分析  

Analysis of temporomandibular joint spaces in patients after over-erupted third molar extraction based on CBCT images

作　　者：李晅 刘慧 朱忆颖 陈霜 钟晓琪 李强 杨志诚 LI Xuan;LIU Hui;ZHU Yi-ying;CHEN Shuang;ZHONG Xiao-qi;LI Qiang;YANG Zhi-cheng(Shanghai Stomatological Hospital&School of Stomatology,Fudan University,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases,Fudan University,Department of Orthodontics,Shanghai 200001,China;Shanghai Stomatological Hospital&School of Stomatology,Fudan University,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases,Fudan University,Department of Maxillofacial Surgery,Shanghai 200001,China;Shanghai Stomatological Hospital&School of Stomatology,Fudan University,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases,Fudan University,Department of Prosthodontics,Shanghai 200001,China)

机构地区：[1]上海市口腔医院,上海市颅颌面发育与疾病重点实验室口腔正畸科,上海200001 [2]上海市口腔医院,上海市颅颌面发育与疾病重点实验室口腔颌面外科,上海200001 [3]上海市口腔医院,上海市颅颌面发育与疾病重点实验室口腔修复科,上海200001

出　　处：《临床口腔医学杂志》2022年第1期41-44,共4页Journal of Clinical Stomatology

基　　金：2019年上海市口腔病防治院院级课题资助项目(编号:SSDC-2020-CR02)。

摘　　要：目的:探讨第三磨牙伸长与颞下颌关节(TMJ)各关节间隙变化的关系。方法:收集第三磨牙伸长患者56例临床资料,根据第三磨牙伸长位置、数目分为单颗、双颗单颌、双颗同侧、双颗异颌、三颗第三磨牙伸长组。拔除伸长第三磨牙前后(间隔6月以上),对比受试者TMJ各间隙的CBCT变化情况。结果:单颗组单侧上颌第三磨牙伸长者,拔牙前后,非伸长侧关节前、上间隙变窄;单侧下颌第三磨牙伸长者,拔牙前后,伸长侧关节前、上间隙变窄(P<0.05)。双颗组双侧下颌第三磨牙伸长者,拔牙后双侧上间隙变窄(P<0.05);双侧上颌第三磨牙伸长者、异侧第三磨牙两颗伸长者,各关节前间隙变化不明显。三颗组3颗第三磨牙伸长者,关节间隙在拔牙前后的间隙变化与无对颌第三磨牙伸长侧相关。结论:第三磨牙伸长引起[牙合]干扰,可能改变TMJ间隙,致使髁突移位,是TMD潜在可能致病因素之一。Objective:To evaluate the variation of temporomandibular joint spaces of patients with the over-erupted third molar before and after extraction based on CBCT images.Methods:The clinical data of 56 patients were collected and divided into 3 groups which are single molar over-erupted,double-molar over-erupted and three-molar over-erupted.All the patients took the CBCT images before and after the third molar exaction(at least after 6 months)and joint spaces were measured.Results:In single molar over-erupted group:anterior and superior joint spaces on the opposite side were narrower after maxillary molar extraction,while anterior and superior spaces on the same side were narrower after mandibular molar extraction(P<0.05).In double-molar over-erupted group:the superior joint spaces on both sides were narrower after two lower third-molar extraction(P<0.05).No significant space changed after two upper third-molars extraction or two third-molars in different sides.In three-molar over-erupted group:the changes of joint spaces after extraction were closely related to the over-erupted third molar without paired tooth.Conclusion:The over-erupted third molar perhaps cause interference in occlusion,induced TMJ space change,which may be one of the potential pathogenic factors of TMD.

关 键 词：颞下颌关节 关节间隙 CBCT 第三磨牙伸长 [牙合]干扰 

分 类 号：R816.98[医药卫生—放射医学] R782[医药卫生—临床医学]