可复性关节盘前移位对颞下颌关节三维形态学参数的影响

Three-dimensional morphological changes in the temporomandibular joints of patients with anterior disc displacement with reduction

目的通过三维形态学测量方法探究可复性关节盘前移患者(ADDwR)与正常人颞下颌关节(TMJ)的差异。方法招募了15名ADDwR患者和10名无症状的正常人,在MIMICS 20.0软件中重建出上、下颌骨的三维模型,在三维模型上测量双侧TMJ的9个形态学参数,分析ADDwR患者患病侧与正常人两侧之间的差异。结果ADDwR患者患侧的水平髁突角、冠状髁突角均显著大于正常人(P<0.01),矢状升支角、关节腔内间隙、关节腔外间隙、关节腔上间隙、关节腔前间隙和关节腔后间隙均显著小于正常人(P<0.01)。结论ADDwR将导致患病侧的髁突角显著大于正常人,下颌矢状升支角、关节间隙显著小于正常人,从而导致髁突向上移位,更接近关节窝。

Objective To investigate the differences in the temporomandibular joints(TMJs)between patients with anterior disc displacement with reduction(ADDwR)and asymptomatic subjects by using 3D morphometric measurements.Methods A total of 15 patients with ADDwR and 10 asymptomatic subjects were enrolled.Then,3D models of the maxilla and mandible were reconstructed using MIMICS 20.0.Nine morphologic parameters of TMJs on both sides were measured on the 3D solid model.The differences in the parameters were analyzed between the patients and the asymptomatic subjects and between the left and right sides of each group.Results The horizontal and coronal condylar angles on the ipsilateral side of the patients were significantly greater than those of the asymptomatic subjects(P<0.01).Meanwhile,the sagittal ramus angle(SRA),medial joint space,lateral joint space,superior joint space,anterior joint space,and posterior joint space in the patients were significantly lower than those in the asymptomatic subjects(P<0.01).Conclusion ADDwR will increase the condylar angles to be significantly greater than the normal level and decrease SRA and articular spaces to be significantly smaller than the normal level.The condyles will be displaced upward,closer to the fossa.