颞下颌关节退行性改变与颅面形态及颞下颌关节形态结构的关联  

Association of the degenerative changes of the temporomandibular joint with craniofacial morphology and the internal structures of temporomandibular joint

作　　者：张桃李 龚衍吉 刘方 张秦兰蕙 刘洋[1] Zhang Taoli;Gong Yanji;Liu Fang;Zhang Qinlanhui;Liu Yang(State Key Laboratory of Oral Diseases&National Center for Stomatology&National Clinical Research Center for Oral Diseases&Dept.of Temporomandibular Joint,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病防治全国重点实验室、国家口腔医学中心、国家口腔疾病临床医学研究中心、四川大学华西口腔医院颞下颌关节科,成都610041

出　　处：《国际口腔医学杂志》2024年第5期642-652,共11页International Journal of Stomatology

基　　金：四川省自然科学基金项目(2023NSFSC0568);四川大学华西口腔医院临床医学研究项目(LCYJ2023-YF-3)。

摘　　要：颞下颌关节退行性关节病在影像学上多表现为髁突骨质破坏、增生、硬化、囊样变或者髁突形态上的短小畸形,其病因复杂。相关临床研究发现,骨性Ⅱ类或高角骨面型的个体多见颞下颌关节退行性变,偏颌人群中的患病率也较高;同样有较多的研究提示,髁突骨质退行性改变与不可复性关节盘移位等颞下颌关节形态结构存在关联,其中的因果关系目前尚不完全明确。本文主要从解剖学特征方面综述颞下颌关节退行性改变与颅面形态的相关性及与关节内部形态结构的相关性,最后从生物力学的角度来探讨颞下颌关节退行性改变的可能原因,以期为临床工作者了解该疾病及制订临床决策提供参考。Owing to their complex etiologies,degenerative temporomandibular joint(TMJ)diseases are characterized through the imaging of condylar bone destruction,hyperplasia,sclerosis,cystic changes,or morphological shortening of the condyle.Relevant clinical studies have found that TMJ degenerations are common in patients with skeletal ClassⅡor hyperdivergent deformities and those with facial asymmetry.A link has been found between degenerative changes in the condyle and conditions such as articular disk displacement without reduction(DDw/oR)in the TMJ structures.Nevertheless,the causes and effects of the correlation remain unclear.In this work,the relationship between TMJ degenerative changes and craniofacial morphology and the internal structures of the joints were reviewed from an anatomical point of view.Finally,the possible causes of TMJ degenerations were discussed from the biomechanical point of view to provide a reference for clinicians to understand TMJ degenerations and make clinical decisions.

关 键 词：下颌髁突 退行性关节疾病 颞下颌关节 骨面型 偏颌 错[牙合]畸形 

分 类 号：R782.6[医药卫生—口腔医学]