前牙反矫治前后颞下颌关节形态结构改变MRI研究

Effects of Orthodontic Treatment on Temporomandibular Joint of Patients with Adult Functional Class Ⅲ Malocclusion by MRI

目的研究成人功能性反病例治疗前后颞下颌关节髁突位置、关节盘位置的结构变化,及其与临床症状、体征的相互关系。方法利用MRI成像分析12例成人反病例治疗前后髁突位置和关节盘位置变化,并通过Helkimo指数评价治疗前后颞下颌关节功能。结果Ⅲ类功能性反病例治疗前髁突位于关节窝的前位,治疗后髁突位于关节窝的中位,关节盘位置治疗前后变化无显著差异。关节盘位置正常的病例,关节的临床症状和体征治疗前后无明显变化;关节盘前移位的病例,治疗后主诉症状和临床体征有加重趋势。结论成人功能性反病例通过正畸治疗髁突位于关节窝中位,有利于行使关节的正常功能。

Objective To evaluate the effects of orthodontic treatment on temporomandibular joint morphological changes of patients with adult functional Class Ⅲ malocclusion and to find out whether these were related to clinic symptoms and signs.Methods 12 patients were examined by MRI before and after treatment to study the changes of the position of condyle and meniscus to evaluate the function of temporomandibular joint by Helkimo index.Results Before treatment functional Class Ⅲ patients demonstrated more anteriorly positioned condyles.After treatment functional Class Ⅲ patients demonstreated concentricly positioned condylers,and there is no difference of position of meniscus before and after treatment.The patients with normal meniscus position hadn＇t obvious changes of clinic symptoms and signs.The patients with anterior disc displacement had more severe changes of clinic symptoms and signs.Conclusion Orthodontic treatment induce position of condyle to concentricly positioned and is effective in the treatment of adult functional class Ⅲ malocclusion.