单、双侧第二磨牙正锁[牙合]与颞下颌关节退行性关节病的CBCT研究  

A CBCT study on the relationship between unilateral and bilateral second molar scissors bite and temporomandibular joint degenerative joint disease

作　　者：李爽 张洪宇 易周 王悦[1] LI Shuang;ZHANG Hongyu;YI Zhou;WANG Yue(Department of Orthodontics,School and Hospital of Stomatology,Tianjin Medical University,300070,China)

机构地区：[1]天津医科大学口腔医院正畸科,300070 [2]天津市第三中心医院

出　　处：《实用口腔医学杂志》2023年第6期774-778,共5页Journal of Practical Stomatology

基　　金：天津市教委科研项目(编号:2020KJ184)。

摘　　要：目的:探究单、双侧第二磨牙正锁[牙合]与颞下颌关节退行性关节病之间的关系。方法:纳入双侧第二磨牙正锁[牙合]成人患者30例(双侧组)、单侧第二磨牙正锁[牙合]成人患者30例(单侧组)作为实验组,选择骨性Ⅰ类、后牙咬合正常的成人患者60例作为对照组。所有患者拍摄锥形束CT(CBCT),观察3组患者颞下颌关节有无退行性变并分析退变类型。通过SPSS 26.0统计软件分析数据。结果:双侧组(OR双侧vs对照=6.91,95%置信区间为2.61-18.33,P=0)发生退行性关节病的风险是对照组的6.91倍,单侧组(OR单侧vs对照=3.5,95%置信区间为1.35-9.11,P=0.009)发生退行性关节病的风险是对照组的3.5倍。关节退变类型中以髁突短小、形态改变和骨质破坏最常见,其次是骨质增生、骨质硬化和间隙变窄。结论:第二磨牙正锁[牙合]是颞下颌关节退行性变的危险因素,且双侧第二磨牙正锁[牙合]危险程度高于单侧。Objective:To explore the relationship between unilateral and bilateral second molar scissors bite and temporomandibular joint(TMJ)degenerative joint disease(DJD).Methods:30 adults with bilateral and 30 with unilateral second molar scissors bite were enrolled into the experiment group,60 adults with skeletal class I and normal posterior occlusion were enrolled into the control group.All patients underwent CBCT scan.Invivo 5 software was used to evaluate the TMJ degeneration in the 3 groups and to analyze the types of degeneration.Data were processed by SPSS 26.0 statistical software.Results:The prevalence of TMJ DJD in bilateral second molar scissors bite group(OR bilateral vs control=6.91,95%confidence interval,2.61 to18.33,P=0)and unilateral second molar scissors bite group(OR unilatera lVS control=3.5,95%confidence interval,1.35 to 9.11,P=0.009)was higher than that in control group.The most frequent type of degeneration observed was condylar shortness and morphologic changes,followed by condylar erosion,osteophytes,osteosclerosis and space narrowing.Conclusion:Second molar scissors bite is a risk factor for temporomandibular joint degeneration,and the risk of bilateral second molar scissors bite is higher than that of unilateral.

关 键 词：正锁[牙合] 颞下颌关节 退行性关节病 骨关节病 

分 类 号：R782.6[医药卫生—口腔医学]