不同咬合支持患者髁突位置的锥形束CT研究

Relationship between occlusal support and mandibular condyle position: a CBCT-based analysis

目的通过锥形束CT探讨不同咬合支持患者的颞下颌关节髁突位置的差异。方法选择2013—2016年在南京医科大学附属口腔医院就诊的84例成年患者,利用NNT软件行双侧颞下颌关节间隙和位置分析。不同咬合支持与髁突位置间的相关性采用卡方检验分析。结果患者关节前、后、上间隙大小分别为(2.23±0.79)mm、(1.98±1.18)mm、(3.53±0.99)mm。A类咬合支持22例,B类31例,C类31例。C类咬合支持的患者,其关节后间隙和上间隙明显减小,具有统计学差异(P<0.05)。髁突前位39侧,中位48侧,后位81侧。不同咬合支持的患者,其髁突的位置分布具有统计学差异(P<0.05)。结论缺牙后,咬合支持的改变,可能导致髁突位置的改变。

Objective To determine the relationship between the occlusal support and the condyle position by cone beam CT（CBCT）. Methods A total number of 84 patients who were treated at our institution from 2013 to 2016 were retrospectively included. The space of the bilateral joints and the condyle position were measured with NNT on CBCT multiplanar images. The association between the condyle position and occlusal support was statistically analyzed. Results The mean distances of the anterior, superior and posterior joint space were （2.23±0.79）mm, （1.98±1.18）mm, （3.53±0.99）mm respectively. The occlusal support was classified into type A（22）, type B（31） and type C（31）. The superior and posterior joint spaces were significantly associated with occlusal support. However, no significant relationship was found between occlusal support and anterior joint space. The condyle position was defined as anterior（39 sides）, concentric（48 sides） and posterior（81 sides）.The distribution of condyle position was associated with occlusal support. Conclusions There is a significant correlation between occlusal support change and the condyle position.