颞下颌关节骨关节病不同分期的锥形束CT三维位置比较

Comparison of three-dimensional position on cone beam computed tomography of temporomandibular joint osteoarthrosis

目的探讨颞下颌关节骨关节病(TMJOA)患者在不同骨关节病分期髁突三维影像学特征的差异。方法以2005年马绪臣等提出的骨关节病X线表现分期为标准,将108例TMJOA患者(骨关节病组)的锥形束CT(CBCT)检查结果分为4期,对照组为28例仅存在间隙改变的颞下颌关节紊乱病患者;评价TMJOA CBCT征象不同分期时髁突的矢状面位置,并对2组的髁突水平角进行比较。结果 TMJOA不同分期髁突矢状面位置无统计学差异,但髁突水平角有统计学差异(F=3.872,P=0.005),进一步两两分析表明,第1期髁突水平角低于第2和3期(P=0.027,P=0.000);第2期对照组髁突水平角低于第3期(P=0.004,P=0.047)。结论 TMJOA患者在不同分期时髁突矢状面位置差异不明显,但髁突水平角存在差异,该角度的变化对TMJOA的分期有一定提示意义。

Objective This study investigates the effect of temporomandibular joint osteoarthritis （TMJOA） on different stages of condylar three-dimensional position and provides a theoretical basis for clinical application. Methods The cone beam computed tomography （CBCT） images of 108 TMJOA patients were analyzed and divided into four stages based on the stage standard of osteoarthrosis X-ray performance proposed by Xuchen Ma in 2005. A total of 28 defect-free temporomandibular joint disorders were used as the control group. Differences in condylar position and condylar axis horizontal angle were evaluated and compared. Results No significant differences were found in terms of sagittal relationship, but condylar axis horizontal angle showed a significant difference （F=3.872, P=0.005）. The horizontal angle values of stage 1 in the TMJOA group were lower than those in stages 2 and 3 （P=0.027, P=0.000）, whereas the horizontal angle values of stage 2 and control groups were lower than those of stage 3 group （P=0.004, P=0.047）. Conclusion Condylar horizontal angle differed in each stage of TMJOA, but no significant difference between the parasagittal positions of the condyles was observed in each stage.