Journal of Prevention and Treatment for Stomatological Diseases ›› 2021, Vol. 29 ›› Issue (7): 468-473.DOI: 10.12016/j.issn.2096-1456.2021.07.006

• Clinical Study • Previous Articles     Next Articles

Evaluation of temporomandibular joint space and condylar morphology in patients with anterior open-bite based on cone-beam CT

LAI Zhanwen1(),HU Ziyang2,PAN Xiao2,HAO Yanqing2,LIN Zitong2()   

  1. 1. Guangxi Institute of Occupational Disease Prevention and Control & Guangxi Workers′ Hospital, Nanning 530000, China
    2. Nanjing Stomatological Hospital, Medical School of Nanjing University, Department of Dentomaxillofacial Radiology Imaging, Nanjing 210008, China
  • Received:2021-01-08 Revised:2021-02-27 Online:2021-07-20 Published:2021-04-19
  • Contact: Zitong LIN
  • Supported by:
    Natural Science Foundation of Jiangsu Province(BK20141083)

前牙开牙合患者颞下颌关节间隙及髁突形态的锥形束CT评价

赖展文1(),胡子洋2,潘笑2,郝燕清2,林梓桐2()   

  1. 1.广西壮族自治区职业病防治研究院(广西壮族自治区工人医院),广西壮族自治区 南宁(530000)
    2.南京大学医学院附属 口腔医院,南京市口腔医院口腔颌面医学影像科,江苏 南京(210008)
  • 通讯作者: 林梓桐
  • 作者简介:赖展文,学士,Email: 354889268@qq.com
  • 基金资助:
    江苏省自然科学基金(BK20141083)

Abstract:

Objective To investigate the difference of the temporomandibular joint between patients with anterior open-bite and normal overbite with cone beam CT (CBCT).Methods Fifty-four patients with anterior open bites and 54 patients with normal overbites were selected from the Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University from June 2014 to August 2020. Sagittal and coronal images of the temporomandibular joint were reconstructed with multiplanar reconstruction techique. The Kamelchuk method was used to measure the superior, posterior and anterior space of the temporomandibular joint, and the condylar morphology was divided into two types: normal and abnormal. The joint space and condylar morphology of the anterior open-bite group and the normal overbite group were statistically analyzed. The anterior open-bite group was divided into 3 subgroups: ① Ⅰ° open-bite (open bite distance < 3 mm), ② Ⅱ° open-bite (open bite distance ≥ 3 mm and ≤ 5 mm) and ③ Ⅲ° open-bite (open bite distance > 5 mm). The difference of overbite spaces of the temporomandibular joint was compared among these three subgroups.Results Compared to the normal group, no significant differences were found for the anterior and superior space of the temporomandibular joint in the anterior open-bite group (P > 0.05), but the posterior space increased significantly (P < 0.01). A total of 52.8% of patients in the anterior open-bite group had abnormal condyles, whereas 21.3% of patients in the normal group, overbite significant differences was found between the two groups (P < 0.01). Compared with patients with Ⅰ° and Ⅱ° openbite, the condyle of patients with III° open bites was more forward in the fossa (P < 0.05).Conclusion The position of the condyle in the fossa of patients with anterior open bites is more forward, and abnormal condylar bone is more common found.

Key words: cone-beam CT, temporomandibular joint, anterior space, superior space, posterior space, condylar morphology, anterior open-bite, normal overbite, orthodontic treatment

摘要:

目的 应用锥形束CT(cone-beam CT,CBCT)对前牙开牙合患者的颞下颌关节间隙及髁突形态进行测量分析,探讨前牙开牙合患者与正常覆牙合患者的颞下颌关节的差异。方法 选取2014年6月至2020年8月于南京大学医学院附属口腔医院正畸科就诊的前牙开牙合患者54例(前牙开牙合组)和正常覆牙合患者54例(正常覆牙合组),对其拍摄的颌面部CBCT图像使用多平面重建技术重建颞下颌关节矢状位及冠状位图像。使用Kamelchuk法测量颞下颌关节上、后、前间隙,根据髁突骨质情况 将髁突形态分为正常型与异常型2类,对前牙开牙合组和正常覆牙合组进行关节间隙及髁突形态的统计学分析。将前牙开牙合组根据开牙合的程度分为3个亚组:① Ⅰ°开牙合组(开牙合距离<3 mm);② Ⅱ°开牙合组(3 mm ≤ 开牙合距离 ≤ 5 mm);③ Ⅲ°开牙合组(开牙合距离>5 mm),比较3个亚组间关节间隙的差异。结果 前牙开牙合组与正常覆牙合组相比,颞下颌关节前、上间隙差异无统计学意义(P > 0.05),颞下颌关节后间隙显著增宽(P<0.01);前牙开牙合组髁突骨质异常占52.8%,正常覆牙合组骨质异常占21.3%,两组间具有显著性差异(P<0.01)。与Ⅰ°和Ⅱ°前牙开牙合患者相比,Ⅲ°前牙开牙合患者髁突在关节窝内更靠前(P<0.05)。结论 前牙开牙合患者的髁突在关节窝内位置更加靠前、髁突骨质异常比例较高。

关键词: 锥形束CT, 颞下颌关节, 前间隙, 后间隙, 上间隙, 髁突形态, 前牙开牙合, 正常覆牙合, 正畸治疗

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