山东大学学报 (医学版) ›› 2021, Vol. 59 ›› Issue (6): 117-121.doi: 10.6040/j.issn.1671-7554.0.2020.1573
刘学业1,李齐明2,唐弘毅1,徐秋平1,陈文倩1,郭泾1
LIU Xueye1, LI Qiming2, TANG Hongyi1, XU Qiuping1, CHEN Wenqian1, GUO Jing1
摘要: 目的 探讨年轻成人双侧颞下颌关节(TMJ)髁突体积、表面积和形态学指数(MI)与关节盘矢向位置的关系。 方法 选自2019年1月至2020年12月于山东大学口腔医院正畸科就诊的患者,因正畸需要拍摄锥形束CT(CBCT),与受试者交流沟通后,经受试者同意拍摄双侧TMJ核磁共振成像(MRI),共纳入44例受试者,其中男20例,女24例,18~30岁,平均(24.5±3.3)岁。将CBCT数据导入Mimics 20.0中,对髁突进行三维重建,Mimics 20.0自动计算髁突体积、表面积,MI=髁突体积/表面积。MRI定量评估TMJ关节盘矢向位置。根据双侧TMJ关节盘矢向位置,将每例受试者关节盘矢向位置靠前一侧的髁突体积、表面积、MI数据分至G1组,另一侧数据分至G2组。 结果 不同侧的髁突体积、表面积和MI差异有统计学意义(P<0.001),男性与女性的髁突体积、表面积和MI差异无统计学意义(P>0.05)。髁突体积和表面积与代表TMJ关节盘矢向位置的角度呈负相关(P=0.026; P=0.037),G2组髁突体积、表面积、MI均值大于G1组且差异有统计学意义(P<0.001; P=0.004; P=0.014)。 结论 年轻成人不同侧髁突体积、表面积及MI存在差异,不同性别间未见差异。年轻成人髁突体积和表面积与TMJ关节盘矢向位置呈负相关。
中图分类号:
[1] Lai YC, Yap AU, Türp JC. Prevalence of temporomandibular disorders in patients seeking orthodontic treatment: a systematic review [J]. J Oral Rehabil, 2020, 47(2): 270-280. [2] 郑有华, 张志光, 孔繁军, 等. 颞下颌关节盘移位中国专家共识研讨会纪要[J]. 中华口腔医学杂志, 2017, 52(7): 443-444. ZHENG Youhua, ZHANG Zhiguang, KONG Fanjun, et al. Summary of Chinese expert consensus workshop on temporomandibular joint disc displacement [J]. Chinese Journal of Stomatology, 2017, 52(7): 443-444. [3] Matsubara R, Yanagi Y, Oki K, et al. Assessment of MRI findings and clinical symptoms in patients with temporomandibular joint disorders[J]. Dentomaxillofac Radiol, 2018, 47(4): 20170412. [4] Kumar R, Pallagatti S, Sheikh S, et al. Correlation between clinical findings of temporomandibular disorders and MRI characteristics of disc displacement [J]. Open Dent J, 2015, 9: 273-281. doi: 10.2174/1874210601509010273. [5] Marpaung C, van Selms MKA, Lobbezoo F. Temporomandibular joint anterior disc displacement with reduction in a young population: Prevalence and risk indicators [J]. Int J Paediatr Dent, 2019, 29(1): 66-73. [6] 傅开元. 颞下颌关节紊乱病影像学检查的必要性以及存在的问题[J]. 中华口腔医学杂志, 2019, 58(8): 505-509. FU Kaiyuan. Necessity and normalization ofimaging examination on temporomandibular disorders[J]. Chinese Journal of Stomatology, 2019, 58(8): 505-509. [7] Jaryna Eder, Pavol Szomolanyi, Martina Schmid-Schwap, et al. Early diagnosis of degenerative changes in the articular/fibrocartilaginous disc of the temporomandibular joint in patients with temporomandibular disorders using delayed gadolinium-enhanced MRI at 3 Tesla-preliminary results [J]. Magn Reson Imaging, 2020, 67: 24-27. doi: 10.1016/j.mri.2019.12.002. [8] Maizlin ZV, Nutiu N, Dent PB, et al. Displacement of the temporomandibular joint disk: correlation between clinical findings and MRI characteristics [J]. J Can Dent Assoc, 2010, 76: 3. [9] Kuhn FP, Spinner G, Del Grande F, et al. MR imaging of the temporomandibular joint: comparison between acquisitions at 7.0 T using dielectric pads and 3.0 T [J]. Dentomaxillofac Radiol, 2017, 46(1): 20160280. [10] Dings JP, Verhamme L, Merkx MA, et al. Reliability and accuracy of cone beam computed tomography versus conventional multidetector computed tomography for image-guided craniofacial implant planning: an in vitro study [J]. Int J Oral Maxillofac Implants, 2019, 34(3): 665-672. [11] McDonald F. The condylar disk as a controlling factor in the form of the condylar head [J]. J Craniomandib Disord, 1989, 3(2): 83-86. [12] Legrell PE, Isberg A. Mandibular height asymmetry following experimentally induced temporomandibular joint disk displacement inrabbits [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1998, 86(3): 280-285. [13] Legrell PE, Isberg A. Mandibular length and middle asymmetry after experimentally induced temporomandibular joint disc displacement in rabbits [J]. Am J Orthod Dentofacial Orthop, 1999, 151(3): 247-253. [14] Bryndahl F, Eriksson L, Legrell PE, et al. Bilateral TMJ disk displacement induces mandibular retrognathia [J]. J Dent Res, 2006, 85(12): 1118-1123. [15] Cai XY, Jin JM, Yang C. Changes in disc position, disc length, and condylar height in the temporomandibular joint with anterior disc displacement: a longitudinal retrospective magnetic resonance imaging study [J]. J Oral Maxillofac Surg, 2011, 69(11): 340-346. [16] Xie Q, Yang C, He D, et al. Will unilateral temporomandibular joint anterior disc displacement in teenagers lead to asymmetry of condyle and mandible? A longitudinal study [J]. J Craniomaxillofac Surg, 2016, 44(5): 590-596. [17] Incesu L, Ta?瘙塂kaya-Yilmaz N, Ogütcen-Toller M, et al. Relationship of condylar position to disc position and morphology [J]. Eur J Radiol, 2004, 51(3): 269-273. [18] Tecco S, Saccucci M, Nucera R, et al. Condylar volume and surface in Caucasian young adult subjects [J]. BMC Med Imaging, 2010, 10: 28. doi: 10.1186/1471-2342-10-28. [19] 冯刚, 周建萍, 吴杨, 等. 锥束CT测量安氏Ⅰ类错牙合人群下颌髁突的体积和表面积[J]. 中国组织工程研究与临床康复, 2011, 15(43): 8014-8018. FENG Gang, ZHOU Jianping, WU Yang, et al. Condyle volume and surface area in young Chinese people with Angles class Ⅰ malocclusion: a cone-beam CT study [J]. Journal of Clinical Rehabilitative Tissue Engineering Research, 2011, 15(43): 8014-8018. [20] Ogura I, Kaneda T, Mori S, et al. Magnetic resonance characteristics of temporomandibular joint disc displacement in elderly patients [J]. Dentomaxillofac Radiol, 2012, 41(2): 122-125. [21] Saccucci M, DAttilio M, Rodolfino D, et al. Condylar volume and condylar area in class I, class II and class III young adult subjects [J]. Head Face Med, 2012, 8: 34. doi: 10.1186/1746-160X-8-34. [22] Seo BY, An JS, Chang MS, et al. Changesin condylar dimensions in temporomandibular joints with disk displacement [J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2020,129(1): 72-79. [23] Chang MS, Choi JH, Yang IH, et al. Relationships between temporomandibular joint disk displacements and condylar volume [J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2018, 125(2): 192-198. [24] 曾丽, 李松. 雌激素对髁突软骨细胞作用的研究进展[J]. 口腔生物医学, 2016, 7(3): 165-167. ZENG Li, LI Song. The Research progress of estrogen hormones effect on mandibular condylar cartilage [J]. Oral Biomedicine, 2016, 7(3):165-167. [25] 刘乙澍, 刘木清, 雷杰,等. 髁突形态过小与颞下颌关节不可复性盘前移位[J]. 口腔医学研究, 2018, 34(3): 307-310. LIU Yishu, LIU Muqing, LEI Jie, et al. Relationship between condylar hypoplasia and temporomandibular joint disc displacement without reduction [J]. Journal of Oral Science Research, 2018, 34(3): 307-310. |
[1] | 赵立星 宋代辉 魏魁杰 殷恺. 颞下颌关节骨关节病动物模型的建立[J]. 山东大学学报(医学版), 2209, 47(6): 25-27. |
[2] | 王煜,尹增正,聂晓琨,马志德,熊世江. 1 125颗下颌第一恒磨牙近中中央根管的CBCT检出率及相关因素分析[J]. 山东大学学报 (医学版), 2022, 60(3): 100-109. |
[3] | 尹增正,聂晓琨,王煜,马志德,熊世江. 800颗上颌第一前磨牙颊根腭侧面沟和根管的CBCT影像形态学观察[J]. 山东大学学报 (医学版), 2021, 59(8): 74-79. |
[4] | 陈虹瑜,曲竹丽,孙琪,赵华强,马川. IL-1β介导的ERK通路对大鼠髁突软骨细胞外基质的作用[J]. 山东大学学报 (医学版), 2019, 57(5): 80-86. |
[5] | 聂晓琨,郝新宇,张淑存,葛堂娜,熊世江. 下颌第一恒磨牙远舌根的锥形束CT研究[J]. 山东大学学报 (医学版), 2019, 57(3): 85-90. |
[6] | 沈倍勇,王晓飞,李军心,周琦. 基于灰度值差的全冠修复体CBCT图像伪影评价方法[J]. 山东大学学报 (医学版), 2019, 57(12): 52-56. |
[7] | 赵茜,孙娜,张风河,宋冬晓,卢正玲. 颞下颌关节及其周围骨性结构的三维测量[J]. 山东大学学报 (医学版), 2019, 57(1): 87-91. |
[8] | 郝新宇,李建华,张静,聂晓琨,熊世江. 上颌第一磨牙根管解剖结构的锥形束CT研究[J]. 山东大学学报 (医学版), 2018, 56(4): 87-91. |
[9] | 张静,杨兴华,李建华,葛堂娜,张淑存,熊世江. 下颌后牙C形根管的锥形束CT研究[J]. 山东大学学报 (医学版), 2018, 56(2): 56-61. |
[10] | 丁凤,董亚兵,赵华强,朱国雄,吴高义. 在慢性睡眠剥夺中骨桥蛋白通过NF-kappaB通路对颞下颌关节的影响[J]. 山东大学学报(医学版), 2016, 54(9): 41-47. |
[11] | 张冰,贾凌璐,贾婷婷,张云鹏,文勇,徐欣. 上颌窦外侧壁牙槽管解剖的锥形束CT研究[J]. 山东大学学报(医学版), 2016, 54(5): 92-96. |
[12] | 韩旭, 邵玉婷, 孙钦凤, 郭泾. 正畸干预前后MIC-CR位髁突位移变化[J]. 山东大学学报(医学版), 2015, 53(8): 61-65. |
[13] | 李德水, 刘盼盼, 史晓昕, 郭泾. 正畸美学区的CBCT测量分析[J]. 山东大学学报(医学版), 2015, 53(2): 75-80. |
[14] | MICHAEL M. P. NG'WANAMASELE, 韩延钊, 张风河, 佟冬冬, 李亮, 程慧娟, 王春玲, 刘东旭. 三维配准方法评价下颌后退手术后上呼吸道的形态学变化[J]. 山东大学学报(医学版), 2014, 52(10): 61-65,71. |
[15] | 张云鹏, 文勇, 唐翠竹, 张冰, 占发龙, 徐欣. 上颌后牙牙根与毗邻解剖结构关系的锥形束CT分析[J]. 山东大学学报(医学版), 2014, 52(10): 66-71. |
|