基于数字化三维重建的髁突解剖学测量与单侧颞下颌关节紊乱病常见症状的相关性分析  

Correlation between condylar anatomical measurement based on digital three-dimensional reconstruction and common symptoms of unilateral temporomandibular joint disorder

作　　者：张开祥 徐锦程[2] ZHANG Kai-xiang;XU Jin-cheng(Department of Stomatology,Bengbu Third People's Hospital Affiliated to Bengbu Medical College,Bengbu,Anhui 233000,China;不详)

机构地区：[1]蚌埠医学院附属蚌埠第三人民医院口腔科,安徽蚌埠233000 [2]蚌埠医学院第一附属医院口腔科,安徽蚌埠233004

出　　处：《中华全科医学》2022年第11期1856-1859,共4页Chinese Journal of General Practice

基　　金：安徽省高校自然科学研究项目(KJ2021ZD0088)。

摘　　要：目的对颌面部CT病例资料进行三维重建和解剖学测量,回顾性分析颞下颌关节紊乱病(temporomandibular joint disorders,TMD)的常见临床症状与髁突形态的相关性。方法选取2020年6月—2021年9月就诊于蚌埠医学院附属蚌埠第三人民医院口腔科的156例患者,根据临床检查及主诉症状分为实验组(弹响组、疼痛组和张口受限组)和对照组(无TMD症状组)。患者于放射科拍摄颌面部CT,通过运行Mimics软件,获取三维重建后的下颌骨髁突形态,并进行解剖学测量。结果对照组的髁突内外径、前后径分别为(21.42±1.93)mm、(11.66±1.22)mm,髁突前后角度为(105.86±6.67)°;弹响组的髁突内外径、前后径以及髁突前后角度分别为(21.47±2.38)mm、(10.64±1.10)mm、(97.38±6.76)°;疼痛组的髁突内外径、前后径以及髁突前后角度分别为(21.25±1.04)mm、(12.17±0.81)mm、(104.00±6.73)°;张口受限组的髁突内外径、前后径以及髁突前后角度分别为(20.48±2.17)mm、(11.55±1.57)mm、(106.79±8.36)°。在有关节弹响的患者中,髁突前后径较对照组减少,髁突前后角度也相应变小;在伴发关节疼痛的患者中,髁突前后径较对照组增大;而张口受限组的髁突形态与对照组比较无明显差异。结论TMD患者的髁突解剖学测量具有一定的差异,可为TMD的辅助诊断提供参考。Objective To retrospectively analyzed the correlation between common clinical symptoms of temporomandibular joint disorders(TMD)and condyle morphology by performing 3D reconstruction and anatomical measurement.Methods A total of 156 patients who were treated in Department of Stomatology,Bengbu Third People's Hospital Affiliated to Bengbu Medical College from June 2020 to September 2021 were divided into experimental group(click group,pain group,and mouth opening limitation group)and control group(no TMD symptom group).The patients were all taken in the Department of Radiology for maxillofacial CT,and three-dimensional reconstruction was performed by Mimics software to obtain the mandibular condyle shape and anatomical measurement was carried out.Results Condylar interior-exterior diameter,condylar anteroposterior diameter,condylar anteroposterior angle in the non TMD symptom group were(21.42±1.93)mm,(11.66±1.22)mm,and(105.86±6.67)°,respectively.These three parameters were(21.47±2.38)mm,(10.64±1.10)mm,(97.38±6.76)°in the click group;(21.25±1.04)mm,(12.17±0.81)mm,(104.00±6.73)°in the pain group;(20.48±2.17)mm,(11.55±1.57)mm,(106.79±8.36)°in the mouth opening limitation group.In the patients with joint snapping,the anterior and posterior condylar diameter decreased,and the anterior and posterior condylar angle also decreased.In patients with joint pain,the anteroposterior diameter of the condyle was larger than that of the control group,while the condyle shape of the mouth opening restriction group had no significant difference from that of the control group.Conclusion Condylar anatomical measurements are different in TMD patients,suggesting that anatomical measurements may provide a assist for diagnosis of TMD.

关 键 词：数字化三维重建 髁突 解剖学测量 颞下颌关节紊乱病 

分 类 号：R782.6[医药卫生—口腔医学]