单、双侧磨牙正锁[牙合]患者颞下颌关节形态和位置的锥形束CT研究  

The cone beam CT study of temporomandibular joint morphology and position in patients with unilateral and bilateral molar scissors bite

作　　者：李爽 马啸宙 谢冰鑫 毛露珈 王瀚平 王悦[1] Li Shuang;Ma Xiaozhou;Xie Bingxin;Mao Lujia;Wang Hanping;Wang Yue(Department of Orthodontics,School and Hospital of Stomatology,Tianjin Medical University,Tianjin 300070,China)

机构地区：[1]天津医科大学口腔医院正畸科,天津300070

出　　处：《中华口腔正畸学杂志》2023年第2期81-85,共5页Chinese Journal of Orthodontics

摘　　要：目的探究单、双侧磨牙正锁[牙合]成人患者颞下颌关节的形态和位置。方法本研究为回顾性研究,选择符合纳入标准的双侧磨牙正锁[牙合]患者30例(双侧组)、单侧磨牙正锁[牙合]患者30例(单侧组)作为实验组,选择后牙咬合基本正常的成人60例作为对照组。所有患者拍摄锥形束CT,导入医学三维影像软件测量并比较颞下颌关节形态和位置。结果比较单侧组的非锁[牙合]侧颞下颌关节、双侧组和对照组的左侧颞下颌关节,结果显示关节前间隙双侧组[中位数(四分位距)为2.36(1.39) mm]大于对照组[1.84(0.69) mm](P=0.011),髁突水平角双侧组(28.28°±10.01°)大于对照组(21.62°±8.39°)(P=0.006),髁突长轴双侧组[中位数(四分位距)为(17.39±2.17) mm]短于对照组[(18.67±3.97) mm](P=0.035);比较单侧组的锁[牙合]侧、双侧组和对照组的右侧颞下颌关节,关节前间隙双侧组[中位数(四分位距)为2.10(1.13) mm]和单侧组[2.22(1.09) mm]大于对照组[1.68(0.69) mm](P=0.006),髁突水平角双侧组(25.23°±11.02°)和单侧组(25.34°±9.88°)大于对照组(20.84°±8.72°)(P=0.044)。单、双侧组髁突不对称程度大于对照组,双侧组髁突长度、髁突高度和冠状面面积不对称指数均大于6%。单、双侧组髁突后移位比例(36.7%,41.7%)显著大于对照组(21.7%)(P=0.021)。结论单、双侧磨牙正锁[牙合]可引起髁突形态的不对称,髁突在关节窝内位置后移且髁突形态短小。Objective To evaluate the morphology and position of temporomandibular joint in adult patients with unilateral and bilateral molar scissors bite.Methods This is a retrospective study.Thirty adults with bilateral molar scissors bite(BSG)and thirty adults with unilateral molar scissors bite(USG)were selected as experiment groups,while 60 adults with normal posterior occlusion were selected as control group(CG).All patients underwent cone beam computed tomography scans,and the data were imported to three-dimensional image software to analyze and compare the morphology and position of temporal mandibular joints.Results Intergroup comparisons for the unaffected side of the UCG and left sides of the other groups revealed that the anterior articular space in the BSG[2.36(1.39)mm]was greater than that in the CG[1.84(0.69)mm](P=0.011);the condylar horizontal angle in the BSG(28.28°±10.01°)was greater than that in the CG(21.62°±8.39°)(P=0.006);and the condyle long axis in the BSG[(17.39±2.17)mm]was shorter than that in the CG[(18.67±3.97)mm](P=0.035).Regarding the scissors bite side of the USG and the right sides of the other groups,the anterior articular space in the BSG[2.10(1.13)mm]and USG[2.22(1.09)mm]was greater than that in the CG[1.68(0.69)mm](P=0.006);and the condylar horizontal angle in the BSG(25.23°±11.02°)and USG(25.34°±9.88°)was greater than that in the CG(20.84°±8.72°)(P=0.044).The asymmetry index in the BSG and USG were larger than that in the CG,which was more than 6%regarding either the condyle length,the height or the coronal section area.The proportion of posteriorly shifted condyles was significantly greater in the USG(36.7%)and BSG(41.7%)than in the CG(21.7%)(P=0.021).Conclusions Unilateral and bilateral molar scissors bite can cause the asymmetry of the condylar morphology.The condyles will shift posteriorly and are relatively shorter and smaller.

关 键 词：正锁[牙合] 颞下颌关节 形态 位置 锥形束CT 

分 类 号：R783.5[医药卫生—口腔医学]