正畸颌位重建治疗伴颞下颌关节紊乱病安氏Ⅱ类2分类成人患者的研究分析  

Analysis of orthodontic treatment with mandibular relocation on temporomandibular joint of classⅡdivision 2 malocclusion with temporomandibular disorders

作　　者：薛青 刘莹[2] 姜娟 陈岱韻 丁晓华 李俊福 XUE Qing;LIU Ying;JIANG Juan;CHEN Daiyun;DING Xiaohua;LI Junfu(Department of Stomatology,The Second Affiliated Hospital of Shandong First Medical University,Taian,Shandong 271000,China;Department of Orthodontics,Stomatology Hospital of Taian City,Taian,Shandong 271000,China;Department of Stomatology,Shandong First Medical University,Jinan,Shandong 250001,China)

机构地区：[1]山东第一医科大学第二附属医院口腔科,山东泰安271000 [2]泰安市口腔医院口腔正畸科,山东泰安271000 [3]山东第一医科大学口腔医学院,山东济南250001

出　　处：《影像研究与医学应用》2024年第24期48-51,共4页Journal of Imaging Research and Medical Applications

基　　金：泰安市科技创新计划项目(2023NS257)。

摘　　要：目的:探讨颌位重建辅助正畸治疗对成人伴有颞下颌关节紊乱病(TMD)安氏Ⅱ类2分类错[牙合]患者颞下颌关节形态及临床症状影响。方法:选取2019年12月—2023年12月于山东第一医科大学第二附属医院口腔正畸科就诊的成年正畸患者44例(伴TMD安氏Ⅱ类2分类19例和个别正常[牙合]25例),均拍摄锥形束CT(CBCT),比较治疗前后颞下[牙合]关节形态、关节弹响变化及主动开口度,以及伴TMD安氏Ⅱ类2分类和个别正常[牙合]的颞下颌关节测量值。结果:伴TMD安氏Ⅱ类2分类患者的关节前间隙大于个别正常牙[牙合]患者,关节后间隙、髁突内外、髁突前后径及髁突高度均小于个别正常[牙合]患者,差异有统计学意义(P<0.05)。伴TMD安氏Ⅱ类2分类患者治疗后关节前间隙缩小,关节窝高度、关节上间隙、关节后间隙、髁突前后径及髁突高度较治疗前增大,差异有统计学意义(P<0.05)。伴TMD安氏Ⅱ类2分类患者15例(78.95%)髁突经治疗后处在关节窝中间位置。结论:成人伴TMD的安氏Ⅱ类2分类患者与个别正常[牙合]的颞下颌关节形态存在一定的差异,正畸联合颌位重建能积极改善此类患者关节紊乱症状,解决此类患者紊乱咬[牙合]关系及异常髁突位置关系的问题。Objective To explore the effect of mandibular relocation combined with orthodontic treatment on the morphology and clinical symptoms of the temporomandibular joint in classⅡdivision 2 malocclusion adolescent with temporomandibular disorder(TMD).Methods A total of 44 adult orthodontic patients who visited the Department of Orthodontics at the Second Affiliated Hospital of Shandong First Medical University from December 2019 to December 2023 were selected(including 19 classⅡdivision 2 malocclusion patients with TMD and 25 individual normal occlusion patients).The cone-beam computed tomography(CBCT)images were used to compare the morphology of temporomandibular joint,the change of joint snapping and the active opening degree before and after treatment,as well as the measurement values of temporomandibular joint with TMD class II division 2 and individual normal occlusion.Results The anterior space in classⅡdivision 2 malocclusion were greater than those in individual normal occlusion patients;while posterior space,inner diameter,condylar medialateral diameter,condylar anteroposterior diameter and condyle height were smaller(P<0.05).Furthermore,After treatment,the anterior articular space of classⅡdivision 2 malocclusion adolescent with temporomandibular disorder was reduced,and the height of the fossa,the supra-articular space,the posterior articular space,the condylar anteroposterior diameter and the condyle height were increased(P<0.05).78.95%of classⅡdivision 2 malocclusion with TMD was in the middle of the articular fossa after treatment.Conclusion There are differences in temporomandibular joint morphology between Class II division 2 patients with TMD compared to individual normal occlusion patients.Orthodontic reconstruction can effectively improve symptoms of temporomandibular joint disorders in these patients as well as address issues related to occlusal relationship and abnormal condylar position.

关 键 词：颌位重建 颞下颌关节紊乱病 安氏Ⅱ类2分类 

分 类 号：R445.3[医药卫生—影像医学与核医学]