稳定性[牙合]板治疗颞下颌关节紊乱病患者后髁突骨密度变化的CBCT研究

Effects of stabilization splint on condylar bone mineral density in patients with temporomandibular disorders:A cone beam computed tomography study

目的利用CBCT测量颞下颌关节紊乱病(TMD)患者稳定性[牙合]板治疗前后髁突骨密度变化,分析稳定性[牙合]板对髁突改建的影响。方法纳入40例稳定性[牙合]板治疗的TMD患者,治疗前后拍摄CBCT。运用MIMICS 21.0软件中Density功能测量髁突皮质骨密度,对髁突前斜面、顶部、后斜面骨密度进行统计学分析。结果治疗前后均显示,女性髁突骨密度显著大于男性;22~40岁年龄组髁突骨密度显著大于13~21岁年龄组;与治疗前相比,治疗后髁突各斜面骨密度显著增加,治疗前后前斜面分别为(347.31±11.98)HU、(367.69±12.98)HU(P=0.003),顶部分别为(310.46±12.40)HU、(331.20±13.56)HU(P=0.012),后斜面分别为(291.55±13.75)HU、(319.94±14.19)HU(P=0.000),增加量在性别、年龄间均无统计学差异(P>0.05)。结论 TMD患者髁突骨密度有性别、年龄间差异,稳定性[牙合]板能促进TMD患者髁突良好改建。

Objective To analyze the effect of stabilization splint on condylar bone remodeling in patients with temporomandibular disorders(TMD) from the aspect of condylar bone mineral density(BMD) changes. Methods Forty TMD patients treated with stabilization splint were selected. Cone beam computed tomography(CBCT) scanning was taken before and after treatment. The condylar BMD was measured by the Density function of MIMICS 21.0 software, and the condylar BMD of the anterior slope, the top and the posterior slope was analyzed statistically. Results Before and after treatment, the condylar BMD in female was significantly higher than that in male(P<0.05). The condylar BMD in 22-40 age group was significantly higher than that in 13-21 age group. Compared with pre-treatment, the condylar BMD increased significantly after treatment. The condylar BMD of the anterior slope was(347.31±11.98) HU before treatment and(367.69±12.98) HU after treatment(P=0.003);that of the top was(310.46±12.40) HU and(331.20±13.56) HU(P=0.012);the posterior slope was(291.55±13.75) HU and(319.94±14.19) HU(P=0.000) respectively. There was no statistical difference of the increment between gender and age(P>0.05). Conclusion There are differences in condylar BMD between gender and age. Stabilization splint is beneficial to TMD patients for a better condylar remodeling.