面部不对称患者颞下颌关节形态位置的锥形束CT研究  

A cone-beam CT study on morphology and position of temporomandibular joint in patients with facial asymmetry

作　　者：王君香[1] 李巍然[2] 王秀婧[1] Wang Junxiang;Li Weiran;Wang Xiujing(Department of First Dental Center,Peking University School and Hospital of Stomatology,Beijing 100034,China;Department of Orthodontics,Peking University School and Hospital of Stomatology,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院第一门诊部,北京100034 [2]北京大学口腔医学院·口腔医院正畸科,北京100081

出　　处：《中华口腔正畸学杂志》2022年第3期143-147,共5页Chinese Journal of Orthodontics

摘　　要：目的利用锥形束CT研究面部不对称患者下颌关节形态位置的特征。方法本研究为回顾性研究。纳入面部不对称患者42例,根据双侧升支高度的差异,分为升支相似组20例,升支不对称组22例;以20例面部基本对称的患者作为对照组。所有患者治疗前拍摄大视野锥形束CT,采用三维测量软件进行三维重建。结果升支不对称组患者的对侧踝突直径明显大于偏斜侧[内外径:对侧(18.44±2.04)mm,偏斜侧(16.18±2.18)mm,P=0.015;前后径:对侧(7.70±1.08)mm,偏斜侧(6.73±1.81)mm,P=0.029]。对侧突前间隙[(2.68±0.68)mm]明显小于偏斜侧[(3.68±0.56)mm],P=0.002。升支不对称组的裸突内外径、高度以及前间隙的差异明显大于对照组和升支相似组[突内外径差:不对称组(2.26±1.32)mm,对照组(0.16±0.22)mm,相似组(0.10±0.85)mm,P=0.003;突高度差:不对称组(3.41±2.94)mm,对照组(0.04±0.57)mm,相似组(-0.41±1.47)mm,P=0.017;前间隙差:不对称组(1.00±0.61)mm,对照组(0.00±0.33)mm,相似组(-0.04±1.07)mm,P=0.020],升支相似组突中心到正中面距离的差异[(-2.60±1.60)mm]明显大于对照组[(-0.10±0.40)mm]和升支不对称组[(0.41±1.35)mm],P=0.004。结论不同类型的不对称患者突形态位置具有不同的特征,双侧关节窝与裸突位置的改变具有一定的关联。Objective,To evaluate the morphology and position of the temporomandibular joint(TMJ)in patients with facial asymmetry by using cone-beam computed tomography(CBCT)data.Methods In this retrospective case-control study,twenty patients with facial symmetry(control group)and 42 patients with facial asymmetry(experimental group)were included,and asymmetric patients were subdivided into two groups according to the difference of ramus height:ramus similar group(n=20)and ramus asymmetry group(n=22).CBCT images were acquired before orthodontic treatment and three-dimensional analyses were performed.ResultsThe condyles of the contralateral side were significantly larger than that of the ipsilateral side in ramus asymmetry group(mediolateral diameter:contralateral side 18.44±2.04 mm,ipsilateral side 16.18±2.18,P=0.015;anteroposterior diameter:contralateral side 7.70 mm±1.08 mm,ipsilateral side 6.73±1.81 mm,P=0.029).The anterior joint space of the ipsilateral side(3.68±0.56 mm)was larger than that of the contralateral side(2.68±0.68 mm)in ramus asymmetry,group(P=0.002).Bilateral dferences in the mediolateral diameter,perpendicular height of the condyles and anterior joint space in ramus asymmetry group.were more evident than those in ramus similar group and the control group(difference of mediolateral diameter:ramus asymmetry group 2.26±1.32 mm,ramus similar group 0.10±0.85 mm,control group 0.16±0.22 mm,P=0.003;dfference of height of the condyles:ramus asymmetry group 3.41±2.94 mm,ramus similar group 0.41±1.47 mm,control group 0.04±0.57 mm,P=0.017;diference of anterior joint space:ramus asymmetry group 1.00±0.61 mm,ramus similar group 0.04±1.07 mm,control group 0.00±0.33 mm,P=0.020).The difference of distance from the center of condyle to medial sagttal plane in ramus similar group 2.60±1.60 mm was more evident than that in ramus asymmetry group 0.41±1.35 mm and the control group.-0.10±0.40 mm(P=0.004).Conclusions:Condyles of different asymmetry patients have different features.The change of articular fossa

关 键 词：面部不对称 锥形束CT 髁突 

分 类 号：R782.6[医药卫生—口腔医学]