恒牙AngleⅢ类错伴颞下颌关节疾病患者髁突运动特征分析

Study of condyle movement in Angle Class Ⅲ malocclusion with temporomandibular dysfunctions

目的 :通过对正常、AngleⅢ类错和AngleⅢ类错伴颞下颌关节疾病(temporomandibular dysfunctions,TMD)患者下颌前伸、后退和开、闭口运动中髁突运动的记录对比,确定AngleⅢ类错伴TMD患者的髁突运动特征,从而为错畸形及TMD的防治提供参考。方法:选择AngleⅢ类错伴TMD患者(实验组)、单纯AngleⅢ类错(对照1组)、正常者(对照2组)各30例,采用计算机化髁突轴图描记仪(CADIAXⅢ)记录下颌功能运动时的髁突运动情况,比较各项测量指标并做定性分析,采用SPSS10.0软件包对髁突各项运动最大值进行定量分析。结果:实验组和对照1组相比,开、闭口,前伸、后退及侧方运动各项指标均大于对照组,尤其在垂直向上,差异显著。实验组与对照2组相比,各项运动在Y轴上变异最大。除左、右侧方运动工作侧大于正常组外,其他各个方向运动范围均小于正常组,尤其在开、闭口运动水平向上和上、右侧方向运动最大空间位移上,差异均有显著性(P<0.01)。结论:AngleⅢ类错伴TMD患者较AngleⅢ类错和正常在三维方向有较典型的髁突运动轨迹。

PURPOSE： Subjects with normal occlusion, Angle Class Ⅲ malocclusion and Angle Class Ⅲ malocclusion with temporomandibular dysfunctions（TMD） were included, and their protraction and retraction, opening and closing mouth were recorded and compared to determine the condyle movement characteristics of Angle Class Ⅲ malocclusion patients with TMD. METHODS： Thirty cases of Angle Class Ill malocclusion with TMD （experimental group）, 30 cases of simple Angle Class Ⅲ malocclusion （control group 1） and 30 cases of normal occlusion （control group 2） were chosen, the condyle movement of mouth opening and closing, protraction and retraction were recorded and analyzed by computer aided axiography （CADIAX m ） , the measurements were compared and qualitative analysis was performed. SPSS 10.0 software package was used for statistical analysis. RESULTS： The indexes of opening and closing mouth, forward, backward and lateral movement were higher in experimental group and control group 1 than in the control group 2, especially in the vertical direction. The maximum variation was on the Y axis between the experimental group and the control group 2, the lateral movement of working side was signifieandy higher than that of the normal group, while the movement ranges at other directions were significantly smaller than that of control group 2, especially in opening and closing mouth horizontally upward and the maximum space displacement at right, upward direction （P〈0.01）. CONCLUSIONS： The tracking of condyle movements has its own characteristics in three dimensions in the experimental group ,compared with control group 1 and 2.