上海口腔医学

上海口腔医学 ›› 2022, Vol. 31 ›› Issue (1): 67-70.doi: 10.19439/j.sjos.2022.01.014

• 论著 • 上一篇    下一篇

368例不同年龄段颞下颌关节盘穿孔患者的临床及锥形束CT分析

刘欢欢1, 蔡恒星2,*, 吴烨1,*   

  1. 1.福建医科大学附属口腔医院 口腔颌面外科,福建 福州 350001;
    2.武汉大学口腔医院 创伤与颞下颌关节外科,湖北 武汉 430079
  • 收稿日期:2021-07-29 修回日期:2021-10-12 出版日期:2022-02-25 发布日期:2022-03-10
  • 通讯作者: 蔡恒星,E-mail: wb000098@whu.edu.cn;吴烨,E-mail: 1713746079@qq.com。*共同通信作者
  • 作者简介:刘欢欢（1985-）,女,硕士,住院医师,E-mail:1019574702@qq.com
  • 基金资助:
    福建省中青年教师教育科研项目（JAT190228）; 福建省自然科学基金（2021J01276）; 福建省卫生健康委省医学创新课题（2020CXB031）

Clinical and cone-beam CT analysis of 368 patients with temporomandibular joint disc perforation in different age groups

LIU Huan-huan1, CAI Heng-xing2, WU Ye1   

  1. 1. Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Fujian Medical University. Fuzhou 350001, Fujian Province;
    2. Department of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, School of Stomatology, Wuhan University. Wuhan 430079, Hubei Province, China
  • Received:2021-07-29 Revised:2021-10-12 Online:2022-02-25 Published:2022-03-10

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摘要： 目的: 探讨不同年龄段颞下颌关节盘穿孔患者的临床及锥形束CT（CBCT）特点。方法: 收集在武汉大学口腔医院口腔颌面外科就诊的颞下颌关节盘穿孔患者的临床及CBCT资料,按年龄段分为6组,分析其临床和影像学特征,包括开口度、疼痛、关节杂音和咬合改变等。采用SPSS 26.0软件包进行统计学分析,比较不同年龄段患者的临床症状及影像特征。结果: 368例患者中,男24例,平均年龄（27.63±15.90）岁;女344例,平均年龄（32.61±15.61）岁。10~19岁年龄组患者疼痛发生率为21.31%,咬合改变占50.82%,髁突吸收扁平占50.82%;20~29岁年龄组患者疼痛发生率为31.06%,咬合改变占53.42%,髁突吸收扁平占45.34%; 50~59岁年龄组患者疼痛发生率为83.33%,咬合改变占2.38%,增生或骨赘形成占47.62%;≥60岁年龄组患者疼痛发生率为82.86%,咬合改变占2.86%,增生或骨赘形成占60%。结论: 颞下颌关节盘穿孔可发生于各年龄段,40岁以下患者易出现咬合改变,CBCT表现为髁突骨量减少;40岁以上患者以疼痛为主要临床表现,CBCT表现为髁突增生性改变。

关键词: 颞下颌关节, 关节盘穿孔, 年龄

Abstract: PURPOSE: The aim of this study was to investigate the clinical characteristics of disc perforation (DP) of temporomandibular joint (TMJ) at different ages. METHODS: Patients with TMJ disc perforation admitted to the Department of Trauma and Temporomandibular Joint Surgery Stomatological Hospital of Wuhan University, from April 2012 to May 2021 were included in this study. They were divided into 6 groups according to different ages. Clinical and CBCT radiographic features were analyzed. Clinical features included maximal interincisal opening, pain, clicking,and occlusal changes. Imaging features included condylar absorption flattening, hyperplasia or osteophyte formation, sclerosis, subchondral cysts, depression defects, and blurred anterior slope. The clinical and imaging characteristics of patients in different age groups were statistically analyzed. SPSS 26.0 software was used for statistical analysis, and Chi-square test was used to compare the distribution of clinical symptoms and imaging features in patients of different ages. RESULTS: A total of 368 patients were collected, including 24 males, with an average age of 27.63±15.90 years. There were 344 females with an average age of 32.61±15.61 years. The incidence of pain was 21.31%, occlusal change was 50.82%, and condylar absorption flat was 50.82% in the 10-19 age group. The incidence of pain in 20-29 age group was 31.06%, occlusal change was 53.42%, and condylar absorption flattening was 45.34%. In 50-59 age group, the incidence of pain was 83.33%, occlusal changes were 2.38%, and hyperplasia or osteophyte formation was 47.62%. In age group ≥60 years old, the incidence of pain was 82.86%, occlusal changes were 2.86%, and hyperplasia or osteophyte formation was 60%. CONCLUSIONS: In terms of clinical features, patients under 40 years old are more likely to have occlusal changes, while patients over 40 years old are most likely to have joint pain. Radiographically, patients under 40 years old are mainly characterized by bone loss in the condyle, while patients over 40 years old are mainly characterized by condylar hyperplasia.

Key words: Temporomandibular joint, Disc perforation, Age

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