术前正畸对骨性Ⅲ类错颌患者颞下颌关节影响的锥形束CT研究

doi:10.7518/hxkq.2019.04.015

华西口腔医学杂志 ›› 2019, Vol. 37 ›› Issue (4): 417-421.doi: 10.7518/hxkq.2019.04.015

术前正畸对骨性Ⅲ类错颌患者颞下颌关节影响的锥形束CT研究

郭美玲¹,黄臻²,王宠³,王予江⁴()

1.南昌大学附属口腔医院综合科江西省口腔生物医学重点实验室
2.南昌大学附属口腔医院正畸科江西省口腔生物医学重点实验室,南昌 330006
3.惠州市口腔医院淡水分院,惠州 516001
4.南昌大学附属口腔医院口腔颌面外科江西省口腔生物医学重点实验室,南昌 330006

收稿日期:2018-09-11 修回日期:2019-05-16 出版日期:2019-08-01 发布日期:2019-08-23
通讯作者: 王予江 E-mail:wang9jiang@sina.com
作者简介:郭美玲,硕士,E-mail：273412804@qq.com
基金资助:
江西省重点研发计划项目(20161BBG70154)

Investigating the effect of pre-surgical orthodontic treatment on temporomandibular joint in patients with skeletal class Ⅲ malocclusion by cone-beam computed tomography

Meiling Guo¹,Zhen Huang²,Chong Wang³,Yujiang Wang⁴()

1. Dept. of General Dentistry, The Affiliated Stomatological Hospital of Nanchang University & Jiangxi Province Key Laboratory of OralBiomedicine, Nanchang 330006, China
2.Dept. of Orthodontics, The Affiliated Stomatological Hospital of Nanchang University & Jiangxi Province Key Laboratory of Oral Biomedicine, Nanchang 330006, China
3.Danshui Branch in Huizhou Stomatological Hospital, Huizhou 516001, China
4.Dept. of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Nanchang University & Jiangxi Province Key Laboratory of Oral Biomedicine, Nanchang 330006, China

Received:2018-09-11 Revised:2019-05-16 Online:2019-08-01 Published:2019-08-23
Contact: Yujiang Wang E-mail:wang9jiang@sina.com
Supported by:
Key Research & Development Project in Jiangxi Province(20161BBG70154)

摘要/Abstract

摘要：

目的探讨术前正畸对行正畸-正颌联合治疗的骨性Ⅲ类错颌患者颞下颌关节（TMJ）的影响。方法选取24例行正畸-正颌联合治疗的骨性Ⅲ类错颌患者,分别在术前正畸完成前后检查并记录关节症状,并行锥形束CT（CBCT）扫描,在三维方向测量髁突各径值（d）、髁突高度（h）、不同角度下关节间隙（L）、双侧髁突间距（R）及各髁突角度值,比较和分析不同时期TMJ症状及骨性结构的变化情况。结果术前正畸前后关节症状无明显改变;颞下颌关节骨性结构在三维方向上的各测量指标均无显著变化（P>0.05）。结论在正畸-正颌联合治疗过程中,术前正畸不会对患者TMJ产生明显影响。

关键词: 术前正畸, 骨性Ⅲ类错颌;, 颞下颌关节, 髁突, 锥形束CT

Abstract:

Objective To investigate the effect of pre-surgical orthodontic treatment on temporomandibular joint (TMJ) in patients with skeletal class Ⅲ malocclusion treated with orthodontic-orthognathic surgical treatment. Methods Twenty-four patients with skeletal class Ⅲ malocclusion who underwent orthodontic-orthognathic surgical treatment were included in the study. Before and after the completion of orthodontic treatment, the symptoms of TMJ were examined and recorded, and the short- and the long-axis diameter of the condylar (d), condylar height (h), joint space (L) at different angles, bilateral condylar spacing (R), and the condylar angles were measured, with scanning performed by using cone-beam computed tomography (CBCT). Then, the changes of TMJ symptoms and bone structure at different periods were analyzed. Results No significant changes were observed in the joint symptoms before and after the pre-surgical orthodontic treatment. No significant changes were found in the measurements of the bone structure of TMJ in the dimensional direction (P>0.05). Conclusion In the orthodontic-orthognathic surgical treatment procedure, the pre-surgical orthodontic process does not have a significant effect on TMJ.

Key words: pre-surgical orthodontic, skeletal class Ⅲ malocclusion;, temporomandibular joint, condylar, cone-beam computed tomography

中图分类号:

R783.5

郭美玲,黄臻,王宠,王予江. 术前正畸对骨性Ⅲ类错颌患者颞下颌关节影响的锥形束CT研究[J]. 华西口腔医学杂志, 2019, 37(4): 417-421.

Meiling Guo,Zhen Huang,Chong Wang,Yujiang Wang. Investigating the effect of pre-surgical orthodontic treatment on temporomandibular joint in patients with skeletal class Ⅲ malocclusion by cone-beam computed tomography[J]. West China Journal of Stomatology, 2019, 37(4): 417-421.

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参考文献 17

[1]	Barghan S, Tetradis S, Mallya S . Application of cone beam computed tomography for assessment of the temporomandibular joints[J]. Aust Dent J, 2012,57(Suppl 1):109-118.
[2]	Kapila S, Conley RS, Harrell WE Jr . The current status of cone beam computed tomography imaging in orthodontics[J]. Dentomaxillofac Radiol, 2011,40(1):24-34.
[3]	王生, 王光耀, 谷志远 . Helkimo指数在颞下颌关节紊乱病研究中的应用[J]. 口腔颌面修复学杂志, 2002,3(2):120-123.
	Wang S, Wang GY, Gu ZY . Application of Helkimo index in the study of temporomandibular disorder[J]. Chin J Prosthodont, 2002,3(2):120-123.
[4]	姜华, 王照五, 刘洪臣 , 等. 牙颌专用CT对颞下颌关节骨性结构的测量技术[J]. 中华老年口腔医学杂志, 2008,6(2):170-172.
	Jiang H, Wang ZW, Liu HC , et al. Measurement of temporomandibular joint osseous structure with dental CT[J]. Chin J Geriatric Dent, 2008,6(2):170-172.
[5]	王照五, 石校伟, 姜华 , 等. 牙颌专用CT的颞颌关节成像技术[J]. 中国医学影像学杂志, 2006,14(6):444-447.
	Wang ZW, Shi XW, Jiang H , et al. Temporomandibular joint imaging of dental special CT[J]. Chin J Med Imaging, 2006,14(6):444-447.
[6]	刘爱民, 张震康, 王兴 , 等. 正颌外科术后髁状突移位的三维CT研究[J]. 现代口腔医学, 2000,3(14):168-170.
	Liu AM, Zhang ZK, Wang X , et al. A study on the condylar displacement following orthognathic surgery by 3-D CT[J]. J Modern Stomatol, 2000,3(14):168-170.
[7]	田慧颖, 周继林, 田晓玲 , 等. 髁状突与关节窝位置关系的三维定量测定[J]. 中日友好医院学报, 1998,12(2):117-121.
	Tian HY, Zhou JL, Tian XL , et al. Three dimensional quantitative measuring study on the condyle-fossa relationships[J]. J China-Japan Friendship Hospital, 1998,12(2):117-121.
[8]	Kim MR, Graber TM, Viana MA . Orthodontics and temporomandibular disorder:a meta-analysis[J]. Am J Orthod Dentofacial Orthop, 2002,121(5):438-446.
[9]	Macfarlane TV, Kenealy P, Kingdon HA , et al. Twenty-year cohort study of health gain from orthodontic treatment: temporomandibular disorders[J]. Am J Orthod Dentofacial Orthop, 2009,135(6):692-698.
[10]	Coêlho TG, Caracas HC. Perception of the relationship between TMD and orthodontic treatment among orthodontists [J]. Dental Press J Orthod, 2015,20(1):45-51.
[11]	赵艳红, 王春玲, 郭杰 , 等. 成人低角骨性Ⅲ类错的位置改变情况非手术矫治对颞下颌关节的影响[J]. 华西口腔医学杂志, 2007,25(5):463-469.
	Zhao YH, Wang CL, Guo J , et al. Effect of non-surgical correction of low grade skeletal Class Ⅲ malocclusion on temporomandibular joint in adults[J]. West China J Stomatol, 2007,25(5):463-469.
[12]	敖同江, 袁小平, 杨四维 , 等. 替牙晚期骨性Ⅲ类错颌矫治对颞下颌关节影响的研究[J]. 实用口腔医学杂志, 2011,27(6):828-831.
	Ao TJ, Yuan XP, Yang SW , et al. Effects of orthodontic treatment on temporomandibular joint of patients with mixed dentition and skeletal class Ⅲ malocclusion[J]. J Pract Stomatol, 2011,27(6):828-831.
[13]	Slade GD, Diatchenko L, Ohrbach R , et al. Orthodontic treatment, genetic factors and risk of temporomandibular disorder[J]. Semin Orthod, 2008,14(2):146-156.
[14]	蹇敦翃, 王汝玲, 郭海鹰 , 等. 成人正畸治疗与颞下颌关节紊乱病的MRI研究[J]. 中华口腔医学杂志, 2012,47(1):137-140.
	Qian DH, Wang RL, Guo HY , et al. Correlations between temporomandibular disorder and orthodontic treatment in adult patients[J]. Chin J Stomatol, 2012,47(1):137-140.
[15]	Baumgaertel S, Palomo JM, Palomo L , et al. Reliability andaccuracy of cone-beam computed tomography dental measurements[J]. Am J Orthod Dentofacial Orthop, 2009,136(1):19-25.
[16]	Gianelly AA, Anderson CK, Boffa J . Longitudinal evaluation of condylar position in extraction and nonextraction treatment[J]. Am J Orthod Dentofacial Orthop, 1991,100(5):416-420.
[17]	蔡凌云 . 正畸治疗对颞下颌关节影响的临床评价[J]. 中国初级卫生保健, 2010,24(4):97-98.
	Cai LY . Clinical evaluation of the effect of orthodontic treatment on temporomandibular joint[J]. Chin Primary Health Care, 2010,24(4):97-98.

分级	术前正畸前	术前正畸后
Ai0	17/70.8	17/70.8
AiⅠ	7/29.2	7/29.2
AiⅡ	0/0	0/0

测量项目	T组	T₀组	t值	P值
d₁/mm	19.558	19.541	1.951	0.063
d₂/mm	8.213	8.191	0.894	0.381
R/mm	123.058	122.967	1.647	0.113
α/°	14.878	14.831	0.581	0.567
L_1-45°/mm	2.422	2.433	-1.068	0.297
L_1-90°/mm	2.150	2.158	-0.123	0.903
L_1-135°/mm	2.204	2.187	0.867	0.395
h/mm	22.007	21.972	0.652	0.521
d₃/mm	8.028	8.013	1.349	0.191
L_2-45°/mm	1.963	1.970	-1.205	0.241
L_2-90°/mm	2.054	2.065	-1.770	0.090
L_2-135°/mm	2.016	2.018	-0.115	0.910
d₄/mm	19.679	19.648	1.412	0.171
β/°	9.987	9.961	1.136	0.268
γ/°	65.961	65.908	1.327	0.198

术前正畸对骨性Ⅲ类错颌患者颞下颌关节影响的锥形束CT研究

Investigating the effect of pre-surgical orthodontic treatment on temporomandibular joint in patients with skeletal class Ⅲ malocclusion by cone-beam computed tomography

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