Association between bone morphology and sagittal disc position in temporomandibular joints of patients with anterior disc displacement

doi:10.7518/hxkq.2022.04.007

Abstract

Abstract:

Objective To analyze the association between sagittal temporomandibular joint (TMJ) disc position of patients with anterior disc displacement evaluated by magnetic resonance imaging (MRI) and bone morphology of the TMJ evaluated by cone-beam computed tomography (CBCT). Methods One hundred and seventy-eight TMJs of 97 patients were retrospectively analyzed. The TMJ disc position was evaluated using MRI and classified into four types: control group (without disc displacement), slight group (disc slightly anteriorly displaced), moderate group (disc moderately anteriorly displaced), and severe group (disc severely anteriorly displaced). The measurements of TMJ bone morphology among four groups were evaluated by CBCT through Mimics software including condyle linear dimensions (condyle length, width, and height), condylar volume and surface area, and the depth and length of the glenoid fossa, joint anterior space, joint superior space, and joint posterior space. The sagittal plane position of the condyle was also assessed. The differences in all the morphologic measurement parameters among the four groups were detected using the one-way analysis of variance or the Kruskal Wallis test, and Chi-square tests. The correlations between disc sagittal position and all the morphologic measurements were also analyzed. Results There were significant differences in measurements of condyle linear dimensions, condylar volume and surface area, depth of the glenoid fossa, joint spaces, and distribution of the condyle sagittal positions among the four groups. By contrast, there were no statistical differences in terms of the length of the glenoid fossa among the four groups. Correlation analysis revealed that there is a statistically significant negative correlation among condyle linear dimensions, condylar volume and surface area, the depth of the glenoid fossa, joint superior space, and disc position. However, joint posterior space was positively correlated with disc position. Conclusion A statistically significant correlation was determined between TMJ bone morphology and different sagittal disc positions. Degenerative changes in TMJ bone morphology clinically diagnosed should be altered, which can be the patients' marker of anterior disc displacement.

Key words: temporomandibular joint, anterior disc displacement, cone beam CT, magnetic resonance ima-ging, sagittal position, morphologic measurement

CLC Number:

R 782.6

Yan Li, Zhou Maoqiang, Qiu Jiaxuan. Association between bone morphology and sagittal disc position in temporomandibular joints of patients with anterior disc displacement[J]. West China Journal of Stomatology, 2022, 40(4): 414-421.

Figures/Tables 6

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Tab 1

Fig 2

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Tab 4

References 26

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测量参数		定义
髁突关节窝	宽度	轴面上测量的最大内外径
	长度	轴面上经过最大内外径中点的垂直线上髁突的最前点与最后点的距离
	体积	利用Mimics软件在轴向上以髁突顶点和下颌切迹最底点所在轴面为上下界，分割建立髁突模型，自动测量体积
	表面积	利用Mimics软件在轴向上以髁突顶点和下颌切迹最底点所在轴面为上下界，分割建立髁突模型，自动测量表面积
	高度	正中矢状面上髁突最顶点到经过下颌切迹最底点所在轴面的最短距离
	长度	正中矢状面上关节结节最低点到关节窝后部最低点的距离
	深度	正中矢状面上关节窝最高点至关节窝宽度线的垂直距离
关节结节	倾斜角	正中矢状面上经过关节窝最高点和关节结节最低点的直线与关节窝长度所在直线所形成的夹角
关节间隙	前	画过关节窝最高点，与髁突前缘相切的线，过切点的垂线上切点到对应关节窝的距离
	上	上关节间隙是从关节窝最上点到髁头最顶点的距离
	后	画过关节窝最高点，与髁突后缘相切的线，过切点的垂线上切点到对应关节窝的距离
髁突位置	前	根据公式：（后间隙-前间隙）/（后间隙+前间隙），若比值R>12%，则为髁突前位
	后	根据公式：（后间隙-前间隙）/（后间隙+前间隙），若比值R<-12%，则为髁突后位
	中	根据公式：（后间隙-前间隙）/（后间隙+前间隙），若比值R介于-12%~12%之间，为髁突中间位

测量参数	对照组	轻度组	中度组	重度组	P值
髁突
宽度/mm	19.69±2.09^a	19.07±1.57^a	18.78±2.11^a	17.32±2.46^b	0.000 1²
长度/mm	8.18±1.20^a	7.95±1.42??	7.16±1.40??	6.73±1.41?	<0.000 1¹
高度/mm	19.30±3.12^a	18.10±2.75^a	17.74±2.56^a	14.86±3.38^b	<0.000 1¹
体积/mm³	2 033±442.1^a	1 832±455.4^a	1 709±422.4^a	1 216±477.9^b	<0.000 1²
表面积/mm²	1 019.0±160.1^a	941.1±158.7^a	917.8±144.4^a	735.2±184.4^b	<0.000 1²
关节窝
深度/mm	6.33±1.16^a	6.31±1.14^a	6.50±1.03^a	5.40±1.57^b	0.000 3¹
长度/mm	18.19±1.77	17.68±2.22	17.26±1.29	18.03±2.02	0.142 1¹
深/长比	0.35±0.06??	0.36±0.06?	0.38±0.05?	0.30±0.09?	<0.000 1²
关节结节倾斜角/?	29.70±4.60??	32.02±6.50^a	32.49±5.33^a	26.33±8.70^b	<0.000 1¹
关节间隙
前/mm	2.33±0.62?	2.67±0.80??	2.89±0.90?	2.54±0.86??	0.021 0²
上/mm	3.57±0.68^a	3.52±0.87^a	3.52±0.86^ab	3.07±1.05^b	0.009 0²
后/mm	2.06±0.53^ab	1.84±0.51^a	2.01±0.60^ab	2.24±0.67^b	0.005 7²
（后-前）/（后+前）/%	-5.97±16.82?	-17.52±16.69?	16.95±20.22?	-5.46±19.22?	0.000 6¹
矢状髁突位置/例（%）					0.044 4³
前	8（15.38）	1（2.00）	3（9.68）	8（17.78）
后	21（40.39）	31（62.00）	20（64.51）	18（40.00）
中	23（44.23）	18（36.00）	8（35.81）	19（42.22）

测量参数		关节盘矢状位置
测量参数		r	P值
髁突	宽度	-0.406 6	<0.000 1
	长度	-0.358 4	<0.000 1
	高度	-0.481 2	<0.000 1
	体积	-0.562 8	<0.000 1
	表面积	-0.541 8	<0.000 1
关节窝	深度	-0.325 2	<0.000 1
关节窝	长度	0.030 7	0.685 6
关节结节	倾斜角	-0.318 1	<0.000 1
关节间隙	前	0.029 8	0.695 6
	上	-0.244 7	0.001 1
	后	0.187 8	0.012 8

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