骨性Ⅰ类和骨性Ⅲ类错[牙合]畸形患者的髁突-关节窝形态特征对比  

A comparative study on morphological characteristics of condyle⁃fossa for skeletal ClassⅠandⅢmalocclusion

作　　者：张程程 周浠 范力文 马兰[1] 潘永初[1] ZHANG Chengcheng;ZHOU Xi;FAN Liwen;MA Lan;PAN Yongchu(Jiangsu Key Laboratory of Oral Disease,Nanjing Medical University,Department of Orthodontics,Affiliated Hospital of Stomatology Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学口腔疾病研究江苏省重点实验室,南京医科大学附属口腔医院正畸科,江苏南京210029

出　　处：《口腔医学》2023年第6期524-528,545,共6页Stomatology

基　　金：国家自然科学基金(81970969);江苏省医学重点学科(zdxka2016026);江苏省科教能力提升工程——江苏省研究型医院(YJXYYJSDW4),江苏省医学创新中心(CXZX202227)。

摘　　要：目的研究骨性Ⅰ类错[牙合]畸形、骨性Ⅲ类错[牙合]伴上颌骨发育不足和骨性Ⅲ类错[牙合]伴下颌骨发育过度患者之间的髁突-关节窝的形态差异。方法收集2021年3月至2022年12月于南京医科大学附属口腔医院正畸科就诊患者,其中包括骨性Ⅰ类错[牙合]畸形、骨性Ⅲ类错[牙合]伴上颌骨发育不足和骨性Ⅲ类错[牙合]伴下颌骨发育过度患者共58例,行锥形束CT扫描,利用Mimics 20.0软件和Dolphin 11.9软件对髁突和关节窝的相关角度及线性指标进行测量评估,采用SPSS 26.0软件进行统计学分析。结果骨性Ⅰ类错[牙合]畸形、骨性Ⅲ类错[牙合]伴上颌骨发育不足和骨性Ⅲ类错[牙合]伴下颌骨发育过度患者,每组患者的左侧和右侧的髁突和关节窝形态一致,差异无统计学意义(P>0.05);骨性Ⅲ类错[牙合]伴上颌骨发育不足和骨性Ⅲ类错[牙合]伴下颌骨发育过度患者均较骨性Ⅰ类错[牙合]畸形患者的髁突上部高度增加(P<0.05);骨性Ⅲ类错[牙合]伴下颌骨发育过度的患者较骨性Ⅰ类错[牙合]畸形患者的关节结节后斜面的倾斜度和关节窝高度减小(P<0.05);骨性Ⅲ类错[牙合]伴上颌骨发育不足和骨性Ⅲ类错[牙合]伴下颌骨发育过度患者之间的各测量值差异均无统计学意义(P>0.05)。结论三组双侧颞下颌关节基本对称,差异无统计学意义;骨性Ⅰ类错[牙合]畸形与骨性Ⅲ类错[牙合]畸形在髁突上部高度、关节结节后斜面倾斜度和关节窝高度存在显著差异;但在骨性Ⅲ类错[牙合]畸形中,上颌骨发育不足患者和下颌骨发育过度患者的颞下颌关节的髁突-关节窝形态特征虽有差异,但不具有统计学意义。Objective To study the morphological differences of condyle⁃fossa in people with skeletal ClassⅠmalocclusion and skeletal ClassⅢmalocclusion who were divided into maxillary deficiency and mandibular prognathism.Methods The CBCT images of bilateral temporomandibular joint(TMJs)in 58 patients with skeletal ClassⅠandⅢwere selected,who were treated in the Depart⁃ment of Orthodontics,Affiliated Hospital of Stomatology Nanjing Medical University from March 2021 to December 2022.Relative angu⁃lar and linear measurements of the condyle⁃fossa were conducted with Mimics 20.0 and Dolphin 11.9 software.The data was analyzed with SPSS 26.0 software.Results There was no statistical difference in the measurement items of TMJs between the left and right sides(P<0.05)in patients with skeletal ClassⅠandⅢmalocclusion.The condyle height of both skeletal ClassⅢmalocclusion was higher than the skeletal ClassⅠmalocclusion(P<0.05).In addition,the comparisons of the skeletal ClassⅢmalocclusion with mandibular prognathism and the skeletal ClassⅠmalocclusion showed statistical differences in the articular eminence inclination and the height of the glenoid fossa(P<0.05).However,the intergroup comparisons of the skeletal ClassⅢmalocclusion showed no statistical differences in all morphological measurements(P>0.05).Conclusion There was no obvious difference between bilateral temporomandibular joints among the three groups.Significant differences were shown between skeletal ClassⅠandⅢmalocclusion in terms of condylar height,the central joint space,the articular eminence inclination,and the height of the glenoid fossa.While there were differences in the mor⁃phological measurements of TMJs among patients with maxillary deficiency and mandibular prognathism of skeletal ClassⅢmalocclu⁃sion,these disparities did not have statistical significance.

关 键 词：髁突 关节窝 骨性Ⅲ类错[牙合]畸形 上颌骨发育不足 下颌骨发育过度 

分 类 号：R783.5[医药卫生—口腔医学]