华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

颞下颌关节盘前移位关节间隙改变的X线研究

王瑞永1,2 马绪臣2,3 张万林3 柳登高3   

  1. 1.北京大学口腔医院口腔颌面外科; 2.颞下颌关节病及口颌面疼痛诊治中心; 3.口腔颌面放射科, 北京100081
  • 收稿日期:2010-06-25 修回日期:2010-06-25 出版日期:2010-06-20 发布日期:2010-06-20
  • 通讯作者: 马绪臣,Tel:010-62179977-2345
  • 作者简介:王瑞永(1970—),男,河南人,主治医师,博士,现在北京市海淀医院口腔科工作

Radiographic study on joint space changes of patients with anterior disc displacement of temporomandibular disorders

WANG Rui-yong1,2, MA Xu-chen2,3, ZHANG Wan-lin3, LIU Deng-gao3   

  1. 1. Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Peking University, Beijing 100081, China; 2. Centre for Temporomandibular Disorders and Orofacial Pain, School and Hospital of Stomatology, Peking University, Beijing 100081, China; 3. Dept. of Oral and Maxillofacial Radiology, School and Hospital of Stomatology, Peking University, Beijing 100081, China
  • Received:2010-06-25 Revised:2010-06-25 Online:2010-06-20 Published:2010-06-20
  • Contact: MA Xu-chen,Tel:010-62179977-2345

摘要:

目的测量颞下颌关节盘前移位患者与健康成人许勒位片上的关节间隙,分析髁突在关节窝中的位置,探讨髁突后移位在关节盘前移位临床诊断中的价值。方法选择120例(120侧)关节盘前移位患者和30例健康成人,拍摄许勒位片,使用AutoCAD计算机软件,采用2种线距测量方法(张震康法和Kamelchuk法)在许勒位片上测量关节间隙,并计算ln(P/A)值,比较关节盘前移位患者与健康成人(对照组)关节间隙的差异。结果2种测量方法的测量结果均显示:关节盘前移位组的关节上间隙和后间隙均小于对照组,其差异有统计学意义(P<0.05),而关节前间隙与对照组的差异无统计学意义(P>0.05);关节盘前移位组ln(P/A)值均小于对照组相应ln(P/A)值,其差异有统计学意义(P<0.05)。结论许勒位片上显示的颞下颌关节髁突后移位在一定程度上提示有关节盘前移位的存在;但正常髁突位置也存在变异,单纯的许勒位片尚不能作为关节盘前移位的确切诊断依据。

关键词: 关节盘前移位, 髁突位置, 关节间隙

Abstract:

Objective To compare the temporomandibular joint space and condylar position on transcranial projections between the patients with anterior disc displacement(ADD) and the healthy controls. To investigate the diagnostic value of the condylar position for the ADD patients. Methods 120 joints of 120 ADD patients and 30 joints of healthy adults, who were taken transcranial projections , were included in this study. The transcranial projections were scanned with precise scanning apparatus and saved as joint photographic group image. The joint spaces were measured with the software of Auto CAD. Two different quantitative methods of joint space measurement, ZHANG Zhen -kang′ s method and Kamelchuk′ s method, were used based on the transcranial projections . The ln(P/A) values were calculated(P:width of the posterior joint space; A: width of the anterior joint space). Concentric position of the condyle was defined if ln(P/A) value was between -0.25 and +0.25. If ln(P/A) was larger than +0.25, the condylar position was defined as anteriorly eccentric. Posteriorly eccentric position was indicated when ln(P/A) value was lower than -0.25. The results were compared and software SPSS 12.0 was used for statistical analysis. Results The results of the two linear measurement methods demonstrated that the superior and posterior joint spaces of the ADD patients were narrower than those of the healthy controls significantly(P <0.05), while the anterior joint spaces of the ADD patients had no significant differences with those of the controls(P>0.05). In addition, there were significant differences in ln(P/A) values of joint spaces between the patients with ADD patients and the controls (P<0.05). Conclusion Posterior position of the condyle could be a sign of existence of ADD, but ADD could not be diagnosed only by the posterior condyle position showed on the transcranial projections because of the variation of the condylar position.

Key words: anterior disc displacement, condylar position, joint space