青春期安氏Ⅱ类1分类患者髁突矢状向位置的锥形束CT测量分析

上海口腔医学 ›› 2014, Vol. 23 ›› Issue (6): 740-743.

青春期安氏Ⅱ类1分类患者髁突矢状向位置的锥形束CT测量分析

方海军¹, 陶列²

1.浙江省中医院下沙院区口腔科,浙江杭州 310018; 2.上海交通大学医学院附属第九人民医院·口腔医学院口腔正畸科,上海市口腔医学重点实验室,上海 200011

收稿日期:2014-03-30 修回日期:2014-05-01 出版日期:2014-12-20 发布日期:2015-01-08
通讯作者: 陶列,E-mail:zhaon1995@126.com E-mail:fhj1518@163.com
作者简介:方海军(1976-),男,学士,主治医师

Evaluation of sagittal temporomandibular condyle position in adolescent Angle Class Ⅱ division 1 patients by cone-beam CT

FANG Hai-Jun, TAO Lie

1.Department of Stomatology, Xiasha College District, Traditional Chinese Medical Hospital of Zhejiang Province. Hangzhou 310018, Zhejiang Province;
2. Department of Orthodontics, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology. Shanghai 200011,China

Received:2014-03-30 Revised:2014-05-01 Online:2014-12-20 Published:2015-01-08

摘要/Abstract

摘要： 目的：应用锥形束CT（CBCT）对青春期安氏Ⅱ类1分类患者的髁突相对于关节窝的矢状向位置进行测量,为Ⅱ类错早期进行下颌前导的功能矫形治疗计划制订提供依据。方法：实验组选用临床无颞下颌关节紊乱症状的青春期安氏Ⅱ类1分类患者40例(男18例,女22例),应用Twin-block功能矫治器进行下颌前导治疗。对照组选用相应年龄阶段骨性安氏I类拥挤、临床无颞下颌关节紊乱症状并存在埋伏阻生牙、需拍摄CBCT的患者44例(男19例,女23例)。2组患者均于治疗前拍摄全头颅CBCT。应用Mimics10.01软件对2组患者关节窝深度、关节窝前壁角度、关节上间隙宽度、关节前间隙宽度及关节后间隙宽度进行测量,应用SPSS15.0软件包对数据进行统计学分析。结果：实验组与对照组患者两侧关节窝深度、关节窝前壁角度、关节上间隙宽度、关节前间隙宽度及关节后间隙宽度均无显著差异（P<0.05）。对安氏Ⅱ类1分类及安氏Ⅰ类对照组2组数据进行配对t检验,显示2组间关节窝深度、关节窝前壁角度及关节上间隙宽度无显著差异（P>0.05）,但关节前间隙宽度及关节后间隙宽度均有显著差异（P<0.05）。结论：青春期安氏Ⅱ类1分类患者与安氏I类患者的关节窝深度、关节窝前壁角度、关节上间隙宽度均无显著差异,但关节前间隙宽度明显减小,而关节后间隙宽度明显增大。该结果提示临床医师在青春期安氏Ⅱ类1分类患者功能矫形治疗前,应考虑患者是否存在髁突的前移代偿。

关键词: 髁突位置, 青春期, 安氏Ⅱ, 类1分类错, 锥形束CT

Abstract: PURPOSE: To evaluate condyle-fossa relationship and provide some evidences for functional orthopedic treatment in adolescent Angle Class Ⅱ division 1 patients. METHODS: Forty adolescent Angle Class II division 1 patients (18 males, 22 females) who have to temporomandibular symptom were involved in this study and 42 adolescent Angle Class I patients (19 males, 23 females) served as control which had impacted teeth needed to take cone-beam CT (CBCT). Mimics 10.01 software was used to measure the depth of the mandibular fossa, the angulation of the posterior wall of the articular tubercle, anterior joint space, superior joint space, posterior joint space in CBCT imaging. Paired t test was applied for comparison between 2 groups using SPSS 15.0 software package. RESULTS: The measured data on left and right side in both Angle Class Ⅱ division 1 patients and Angle Class I patients had no significant differences (P>0.05). The depth of the mandibular fossa, the angulation of the posterior wall of the articular tubercle, the superior joint space have no significant difference (P>0.05). The anterior joint space decreased significantly (P<0.05) and posterior joint space increased significantly (P<0.05) in adolescent Angle Class Ⅱ division 1 patients compared with adolescent Angle Class ⅠI patients. CONCLUSIONS: In adolescent Angle Class Ⅱ division 1 patients, anterior joint space decreased and posterior joint space increased compared with Angle Class Ⅰpatients. And the condyle may move forward for compensation. Orthodontists should pay attention to condyle-fossa relationship in adolescent Angle Class II division 1 patients before functional orthopedic treatment.

Key words: Condyle-fossa relationship, Adolescent, Angle Class Ⅱ, division 1, Cone-beam CT

中图分类号:

R783.5

方海军, 陶列. 青春期安氏Ⅱ类1分类患者髁突矢状向位置的锥形束CT测量分析[J]. 上海口腔医学, 2014, 23(6): 740-743.

FANG Hai-Jun¹, TAO Lie². Evaluation of sagittal temporomandibular condyle position in adolescent Angle Class Ⅱ division 1 patients by cone-beam CT[J]. Shanghai Journal of Stomatology, 2014, 23(6): 740-743.

参考文献

[1] McNamara JJ. Components of Class II malocclusion in children 8-10 years of age [J]. Angle Orthod,1981, 51(3): 177-202.
[2] 于泉,潘晓岗,钱玉芬,等. 安氏Ⅱ类伴下颌后缩患者颞下颌关节窝矢向位置的测量[J].上海口腔医学, 2009,18(1):5-9.
[3] Vitral RW, Telles CS, Fraga MR, et al. Computed tomography evaluation of temporomandibular joint alterations in patients with Class II division 1 subdivision malocclusions: condyle-fossa relationship[J]. Am J Orthod Dentofacial Orthop, 2004, 126(1): 48-52.
[4] Vitral RW, Telles CS. Computed tomography evaluation of temporomandibular joint alterations in Class II division 1 subdivision patients: condylar symmetry [J]. Am J Orthod Dentofacial Orthop, 2002,121(4):369-375.
[5] Krisjane Z, Urtane I, Krumina G, et al. Condylar and mandibular morphological criteria in the 2D and 3D MSCT imaging for patients with Class II division 1 subdivision malocclusion[J]. Stomatologija, 2007, 9(3): 67-71.
[6] Uzel A, Özyürek Y, Öztunç H. Condyle position in Class II Division 1 malocclusion patients: Correlation between MPI records and CBCT images [J]. J World Fed Orthod ,2014, 2(2): e65-e70.
[7] 刘俊玲,李洪发,费丽思,等.恒牙期安氏Ⅱ~1颞下颌关节骨性结构的锥形束CT研究[J]. 口腔医学研究,2013,29(5): 453-456.
[8] 刘博文, 王艳民, 宋芳, 等. 采用锥形束CT分析安氏Ⅱ类1分类错患者Twin-block矫治前后颞下颌关节的变化[J]. 华西口腔医学杂志, 2013,31(6): 610-614.
[9] 史建陆, 檀巧林, 王智军, 等. 锥形束CT对错畸形髁突位置关系研究[J]. 中国实用口腔科杂志,2012,5(5): 295-298.
[10] 曹均凯,王照五,刘洪臣,等. 54例正常人双侧颞下颌关节CBCT测量值分析[J]. 口腔颌面修复学杂志, 2008,9(4): 291-294.
[11] Berghan S. Cone beam computed tomography in the evaluation of the temporomandibular joint [J]. Tex Dent J, 2012, 129:289-302.
[12] White SC. Cone-beam imaging in dentistry[J]. Health Phys. 2008, 95(5): 628-637.
[13] 王丽颖, 金作林. 锥形束CT及其在口腔正畸学中的应用[J]. 国际口腔医学杂志,2013,40(2): 181-184.
[14] 杨臣杰, 钱玉芬, 陈振琦. 锥形束CT在口腔领域的应用[J]. 现代口腔医学杂志, 2010,24(3): 224-227.
[15] Arieta-Miranda JM, Silva-Valencia M, Flores-Mir C, et al. Spatial analysis of condyle position according to sagittal skeletal relationship, assessed by cone-beam computed tomography [J]. Prog Orthod, 2013, 14:36.