关节盘可复性前移位患者再定位咬合板治疗后髁突位置及上气道变化  

Changes in condyle position and upper airway of patients with reducible anterior disc displacement after anterior repositioning splint treatment

作　　者：崔梦琦 张宜爽 袁建桥 张锦 赵芳源 张月兰[1] CUI Mengqi;ZHANG Yishuang;YUAN Jianqiao;ZHANG Jin;ZHAO Fangyuan;ZHANG Yuelan(Department of Orthodontics,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;College of Stomatology,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院正畸科,郑州450052 [2]郑州大学口腔医学院,郑州450052

出　　处：《郑州大学学报（医学版）》2023年第6期769-773,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省医学科技攻关计划省部共建重点项目(SBGJ202102170);正雅“S计划”科研合作项目(K20210043)。

摘　　要：目的:探究颞下颌关节盘可复性前移位患者再定位咬合板治疗后髁突位置及上气道变化。方法:纳入21例颞下颌关节盘可复性前移位患者,采用再定位咬合板治疗6~8个月。治疗前后均拍摄颅颌面锥形束CT,应用三维测量软件进行图像重建及分析,评价治疗后患者关节间隙、髁突位置及上气道变化。结果:再定位咬合板治疗后,关节前间隙减少,上间隙、后间隙增大(P<0.05);治疗前双侧髁突有85.7%居于后位、14.3%居于中位,治疗后双侧髁突78.6%居于前位、21.4%居于中位。再定位咬合板治疗后,上气道总体积、腭咽体积、腭咽最小截面积、腭咽高度、舌咽高度、腭咽矢径、舌咽矢径、腭咽冠径增大,腭咽及舌咽截面矢冠比增大(P<0.05)。结论:再定位咬合板治疗可调整患者髁突位置,缓解颞下颌关节相关症状,同时改善上气道结构及形态。Aim:To explore the changes of condyle position and upper airway of patients with reducible anterior disc displacement after treatment of anterior repositioning splint.Methods::A total of 21 patients with reducible anterior disc displacement were treated by anterior repositioning splint for 6 to 8 months.Cone beam CT were taken and related indexes were measured by three-dimensional analysis software before and after the treatment to evaluate the changes of joint space,condyle position and upper airway.Results:After treatment,the anterior joint space decreased,the superior joint space and the posterior joint space increased(P<0.05).Before treatment,85.7%of bilateral condyles were in the posterior position and 14.3%in the median position,after treatment,78.6%of bilateral condyles were in the anterior position and 21.4%in the median position.After treatment,the total volume of the upper airway,palatopharyngeal volume,palatopharyngeal minimum section,palatopharyngeal height,glossopharyngeal height,palatopharyngeal sagittal diameter,glossopharyngeal sagittal diameter,and palatopharyngeal coronal diameter increased,while the ratio of sagittal to coronal diameter of the palatopharyngeum and glossopharyngeum increased(P<0.05).Conclusion::Anterior repositioning splint could effectively adjust the condyle position,relieving the clinical symptoms and improving the structure and shape of the upper airway.

关 键 词：再定位咬合板 下颌后退 关节盘可复性前移位 上气道 锥形束CT 

分 类 号：R783.5[医药卫生—口腔医学]