Herbst矫治器对颞下颌关节生长的影响

Temporomandibular Joint Growth Changes in Herbst Treatment

目的研究Herbst矫治器对安氏Ⅱ类1分类错患者颞下颌关节产生的影响。方法用Herbst矫治器治疗18例安氏Ⅱ类1分类患者,以X线头影测量方法分析髁突的生长,关节窝移位及TMJ改变。结果Herbst矫治期间,矫治组髁突向后生长量为对照组的两倍,关节窝前下移位,TMJ改变与髁突生长相似,且更加明显。矫治结束后10个月,所有TMJ改变复原,表现为关节窝后移位,髁突生长量和TMJ改变减小,且方向向前。矫治结束后2.5年,所有TMJ改变为生理性的改变。结论Herbst矫治器仅暂时影响TMJ改变量及方向。

Objective To study the effects of Herbst appliance on temporomandibullar joint （TMJ） of patients with Class 11, Division I malocclusion. Methods Eighteen Class Ⅱ , Division Ⅰ malocclusions were treated with the Herbst appliance, the amount and direction of condylar growth, glenoid fessa displacement and TMJ changes were analyzed with cephalometrics. Reastilts It revealed that during the treatment period （T2-T1） condylar growth was directed posteriorly about twice the amount as in the control subjects, and the fossa was displaced in an anterior inferior direction. TMJ changes showed a pattem similar to condylar growth but were more pronounced. During the first posttreatment period （T3-T2）, all TMJ changes reverted. The glenoid fessa was displaced backward; the amount of condylar grows and TMJ changes was reduced, and the changes were more superiorly directed. During the second posttreatment period （T4-T3）, all TMJ changes were considered physiological. Conclusion During Herbst treatment, the amount and direction of TMJ changes （condylar growth, fessa displacement, and TMJ changes） were only temporarily affected favorably by Herbst treatment.