髁突肥大的特征及其与骨关节病的鉴别诊断

Characterization of condylar hyperplasia and its differential diagnosis with osteoarthritis.

目的:分析各类单侧髁突肥大(unilateral condylar hyperplasia,UCH)的特征及提供其与单侧骨关节病(unilateral osteoarthritis,UOA)的鉴别方法。方法:收集UCH与UOA病例,将UCH分为水平型、垂直型与混合型,并分别进行临床检查与CBCT测量分析。结果:水平型及混合型UCH呈较大的颏部偏斜度与下颌体长度差,部分病例对侧前牙区反牙合,这些可作为与UOA的鉴别要点。垂直型1亚类仅有髁突增长,与UOA鉴别要点为下颌体厚度差以及髁突与关节窝的退行性表现。结论:UCH与UOA的鉴别难度可通过对UCH的临床分类分析得到降低。

Objective:To analysis the features of unilateral condylar hyperplasia(UCH)and to provide the methods of differential diagnosis for UCH and unilateral osteoarthritis(UOA).Methods:Patients of UCH and UOA were included and divided into horizontal-,vertical-,combination-type.These patients undertook clinical examinations and cone beam computed tomography.Results:The horizontal and vertical type UCH presented a larger deviation of chin,difference of the length of the mandibular base,and contralateral anterior crossbite in some cases,which could be the points of differential diagnosis between UOA.Vertical subtype 1-UCH presented the sole elongation of the condyle,and its differential diagnostic point between UOA were thickness difference of the mandibular base and the degenerative features of the condyle and glenoid fossa.Conclusion:The difficulty of distinguishing UCH and UOA was decreased by performing classification for UCH.