基于CBCT评价反牙合伴单侧颞下颌关节紊乱病患者颞下颌关节骨性结构及关节间隙改变  

Evaluation of the Bony Structure and Joint Space Changes in Patients with Unilateral TMMD Based on CBCT

作　　者：倪焜 岳志鹏 NI Kun;YUE Zhi-peng(Imaging Department of Yancheng Stomatological Hospital,Jiangsu Yancheng 224005)

机构地区：[1]盐城市口腔医院影像科,江苏盐城224005

出　　处：《中国医疗器械信息》2023年第22期26-28,共3页China Medical Device Information

摘　　要：目的:探讨基于锥形束CT(CBCT)评价反[牙合]伴单侧颞下颌关节紊乱病(TMD)患者颞下颌关节骨性结构及关节间隙改变的价值。方法:选取2019年1月~2022年12月本院收治的112例反[牙合]伴单侧TMD患者,均进行CBCT检查,按反[牙合]牙位分为前后牙均反[牙合]组(观察组,n=23)和非前后牙均反[牙合]组(对照组,n=89)。对比患者健患侧、不同反[牙合]牙位的下颌关节骨性指标、关节间隙差异,并分析骨性结构相关指标、关节间隙预测TMD的价值及TMD患者的骨性结构相关指标、关节间隙与反[牙合]牙位的关系。结果:反[牙合]伴单侧TMD患者的患侧前间隙及关节结节斜度均大于健侧,关节后间隙小于健侧,差异均有统计学意义(P<0.05);ROC曲线分析显示,反[牙合]患者患侧关节前间隙及关节结节斜度均对TMD有预测价值(P<0.05),其AUC分别为0.849、0.638。观察组的患侧关节前间隙、关节上间隙均大于对照组,健患侧的关节斜度均大于对照组,骨密度小于对照组,差异有统计学意义(P<0.05)。spearman相关性分析,反[牙合]伴单侧TMD患者患侧关节前间隙、关节上间隙、关节结节斜度均与反[牙合]牙位呈正相关(P<0.05);骨密度与反[牙合]牙位无明显相关性(P>0.05)。结论:反[牙合]伴单侧TMD患者存在骨性结构改变,最明显的是关节前间隙增宽和关节结节斜度增高,且关节间隙及关节结节斜度改变与反[牙合]牙位存在一定相关性,临床诊断与病情评估中应结合CBCT影像结果。Objective:To explore the value of cone beam CT(CBCT)in evaluating the temporomandibular joint bone structure and joint space changes in patients with crossbite and unilateral temporomandibular joint disorder(TMD).Methods:112 patients with cross bite and unilateral TMD admitted to our hospital from January 2019 to December 2022 were selected and underwent CBCT examination.They were divided into anterior and posterior cross bite patients(observation group,n=23)and non anterior and posterior cross bite patients(control group,n=89)based on the cross bite position.The differences in mandibular joint bone indicators and joint gaps between the healthy and affected sides of patients was compared,as well as between different cross bite positions.And the value of bone structure related indicators and joint space prediction for TMD was analyzed,and the relationship between bone structure related indicators,joint space,and cross bite position in TMD patients was analyzed.Results:Compared with the healthy side,the inclination of the anterior space and joint nodules on the affected side of the with crossbite and unilateral TMD was significantly larger,while the posterior space was significantly smaller,with statistically significant differences(P<0.05).ROC curve analysis showed that the anterior joint space and joint nodule inclination on the affected side of patients with crossbite have predictive value for TMD(P<0.05),with AUCs of 0.849 and 0.638,respectively.The anterior and supraarticular spaces on the affected side of observation group were significantly larger than those of control group,while the joint inclination on the healthy side and the affected side of observation group were significantly larger than that of control group,and the bone density of observation group was lower than that of control group,with a statistically significant difference(P<0.05).Spearman correlation analysis showed that there was a positive correlation between the anterior joint space,suprajoint space,and joint nodule inclination on the affec

关 键 词：反[牙合] 单侧颞下颌关节紊乱病 锥形束CT 骨性结构 关节间隙 

分 类 号：R816.98[医药卫生—放射医学]