上海口腔医学

上海口腔医学 ›› 2019, Vol. 28 ›› Issue (2): 141-147.doi: 10.19439/j.sjos.2019.02.007

• 论著 • 上一篇    下一篇

恒牙列安氏Ⅰ、Ⅱ1、Ⅱ2、Ⅲ类颞下颌关节骨性结构的锥形束CT比较

宋政律1, 钱丽雯1, 程鸣佳1,2, 钱玉芬1   

  1. 1.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,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011;
    2.同济大学附属第十人民医院 口腔科,上海 200072
  • 收稿日期:2018-04-06 修回日期:2018-09-10 出版日期:2019-04-25 发布日期:2019-06-20
  • 通讯作者: 钱玉芬,E-mail：qianyufen2018@163.com
  • 作者简介:宋政律（1991-）,男,硕士,E-mail：darkromens@126.com
  • 基金资助:
    国家自然科学基金（81771104）

Comparison of skeletal structure of temporomandibular joint through cone-beam CT between Angle ClassⅠ, Ⅱ1, Ⅱ2, Ⅲ malocclusion patients with permanent dentition

SONG Jung-yul1, QIAN Li-wen1, CHENG Ming-jia1,2, QIAN Yu-fen1   

  1. 1. Department of Orthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology. Shanghai 200011;
    2. Department of Stomatology, the Tenth People's Hospital affiliated to Tongji University. Shanghai 200072, China
  • Received:2018-04-06 Revised:2018-09-10 Online:2019-04-25 Published:2019-06-20

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摘要： 目的 研究不同性别和安氏Ⅰ、 Ⅱ1、Ⅱ2、Ⅲ类之间颞下颌关节及其周围相关骨性结构的差异。方法 对123例不同安氏分类错畸形患者拍摄锥形束CT（CBCT）,使用Mimics19.0软件进行三维重建,在矢状面上对颞下颌关节的前间隙、上间隙、后间隙、关节窝宽度、关节窝深度、髁突高度、髁突水平角、髁突半径、髁突前后径以及髁突长轴径进行测量分析,对髁突在关节窝的位置采用Pullinger法进行分析。采用SPSS 22.0软件包对数据进行统计学处理。结果 安氏Ⅰ类、Ⅱ1类、Ⅱ2类及Ⅲ类患者中,男性双侧髁突相关骨性结构均显著大于女性,Ⅱ1 类患者髁突长轴径、前后径相对其他类型较小,Ⅲ类骨性患者的关节窝具有宽和浅的特征。安氏Ⅰ类、Ⅱ1类及Ⅲ类患者髁突在关节窝的位置主要为前位或居中,而Ⅱ2类主要为居中或后移位。不同安氏分类法的左右侧髁突相关结构无显著差异（P>0.05）。结论 不同安氏分类法中,错畸形患者的颞下颌关节在髁突形态与结构、关节间隙、关节窝形态及髁突位置等方面存在显著差异。

关键词: 锥形束CT, 颞下颌关节, 安氏分类, 骨性结构

Abstract: PURPOSE: To compare characteristics of temporomandibular joint and related structures according to gender and Angle Ⅰ, Ⅱ1, Ⅱ2 and Ⅲ class. METHODS: Cone-beam CT (CBCT) was performed in 123 patients with malocclusion, and three-dimensional reconstruction was performed with Mimics 19.0 software. The anterior, upper, and posterior spaces of temporomandibular joint, width and depth of acetabulum, height and horizontal angle of condyle, radius of condyle, and anteroposterior and long-axis diameter of condyle were analysed on sagittal plane. The position of condyle in the joint fossa was analyzed using Pullinger methods. SPSS 22.0 software package was used for statistical analysis. RESULTS: Significant differences were found in the long axis and radius of the condyles between Class Ⅰ and Ⅲ, Class Ⅰ and Ⅱ1, respectively (P<0.05). The widest acetabulum was observed in Class Ⅲ, followed by Class Ⅰ, Ⅱ1, and Ⅱ2. Moreover, the deepest acetabulum was found in Class Ⅱ2, followed by Class Ⅱ1, Ⅰ, and Ⅲ. No significant differences were detected in the left and right condyle-related structures among different temporomandibular articulation. In addition, the anterior articular space was significantly larger in Class Ⅰ patients, compared with Class Ⅱ2 patients. CONCLUSIONS: There are significant differences in condylar morphology, joint space, joint fossa morphology and condylar position between different Angle classifications.

Key words: Cone-beam CT, Temporomandibular joint, Angle Class, Skeletal structure

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