锥形束CT重建评价髁突骨性增龄性变化

Age-related changes in condyle evaluated by cone-beam CT reconstruction

背景:锥形束CT能够发现髁突结构及形态的异常改变,包括骨皮质增厚、骨密度异常等,这些改变与颞下颌关节骨关节病密切相关。如何甄别骨关节病的影像学改变是正确诊断和治疗的前提。对于一般人群颞下颌关节各年龄段的髁突生理性改变以及性别差异,目前尚缺乏临床资料研究。目的:采用锥形束CT观察不同性别及年龄人群髁突骨性增龄性变化。方法:收集883例无颞下颌关节症状患者的锥形束CT资料,按年龄(7-8,9-10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26-27,28-29,30-35,36-40,41-45岁)分为22组,采用examvision软件测量髁突表面各点骨密度,并进行统计学分析。结果与结论:随年龄增长,对象髁突最前点、顶点骨密度增高达高峰期,后进入稳定期,40岁后呈下降趋势;髁突最后点骨密度增高,达到高峰后下降,30岁后保持稳定。男女各年龄段髁突最前点、顶点骨密度均大于最后点。各年龄段女性髁突各点骨密度均大于男性。结果证实,髁突骨密度具有一定的增龄性变化规律。髁突功能面骨密度大于非功能面。男性髁突发育迟于女性。实验为颞下颌关节骨性疾病的诊断提供了参考。

BACKGROUND： Cone-beam CT （CBCT） can show abnormal structures and shape of condyle, including thickened cortical bone and abnormal bone mineral density （BMD）, which are closely associated with temporomandibular osteoarthrosis. How to identify the imaging changes of osteoarthrosis is a foundation to make correct diagnosis and treatment. However, there is still a lack of study on physiological changes of condyle in people with different ages and sexes.OBJECTIVE： To investigate the age-related changes of condyle using CBCT in poplulations with different ages and sexes.METHODS： CBCT data of 883 patients without temporomandibular osteoarthrosis were collected, and then divided into 22 groups by age （7-8, 9-10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26-27, 28-29, 30-35,36-40, 41-45）, and the BMD of each point at the surface of condyle was measured using examvision software and analyzed statistically.RESULTS AND CONCLUSION： As age increases, the BMD of the anterior point and apex was increased and reached a peak, then kept on a stable stage, while showed a decreased tendency after 40 years old. The BMD of the posterior point was increased until a peak and then decreased, and became stable after 30 years old. The BMD of the anterior point and apex both was higher than that of the posterior point in male and female patients. The BMD of each point in females all was higher than that in males. Our results suggest that there are age-related changes in condyle BMD. The BMD on the functional surface is higher than that on the nonfunctional surface. Besides, the condyle development of in males is later than that in females, and all above findings provide reference for the diagnosis of temporomandibular osteoarthrosis.