锥形束CT评价骨性Ⅲ类错畸形患者正畸-正颌手术前后髁突位置变化的临床价值研究

Research of condylar positions in skeletal ClassⅢmalocclusion patients with orthodontic-orthognathic treatment by cone beam computed tomography

目的探讨锥形束CT(CBCT)评价骨性Ⅲ类错畸形患者正畸-正颌手术前后髁突位置变化的临床价值。方法回顾性分析2018-09—2020-09于郑州大学第一附属医院口腔正畸科接受正畸-正颌术的骨性Ⅲ类错畸形患者的临床和影像学资料。根据术前1周及术后1 a拍摄的CBCT影像资料,测量患者双侧髁突在关节窝前、上、后间隙的距离,双侧髁突最外侧点间距、最内侧点间距,以及左右髁突内外点连线延长线的交角;记录结果并用SPSS 21.0统计分析软件包对数据进行分析。结果术前1周与术后1 a的双侧髁突各位置间隙变化差异均无统计学意义(P>0.05)。术后1 a的交角小于术前1周,差异有统计学意义(P<0.05);但外距、内距的差异均无统计学意义(P>0.05)。随访期间颞下颌关节均未出现明显关节弹响和疼痛症状。结论根据术前1周及术后1 a拍摄的CBCT影像资料进行测量,正畸-正颌术后1 a髁突位置虽仍会有稍微改变,但变化并不太明显,术后稳定期间患者也未出现明显的关节弹响、疼痛症状,具有相对安全性。

Objective To study the recovery of condylar positions in patients with skeletal classⅢmalocclusion treated with orthodontic-orthognathic after 1 year by cone beam computed tomography.Methods Totally 15 patients with skeletal classⅢmalocclusion who underwent orthodontic-orthognathic surgical treatment were collected,CBCT imaging data were collected with surgical treatment before 1 week and after 1 year.The distance of condylar in anterior,superior and posterior articular fossa was measured before and after operation.Distance was measured between the most medial point of the condylar and between the most lateral point of the condyles,the cutting angle between the axes(Intercondylar Angle)was calculated and measured.SPSS 21.0 software package was used for statistical analysis.Results There was no statistical difference between the bilateral condylar location gaps at 1 week and 1 year(P>0.05).The intersection angle of 1 year was less than 1 week before the operation(P<0.05),but the outer distance had no statistical significance(P>0.05).No significant joint ejection or pain occurred during follow-up.Conclusion According to the CBCT image data taken 1 week before and 1 year after surgery,the 1 year condyle position after orthodontic-orthodibular will still change slightly,but the changes are not obvious,and the patients have no obvious joint ringing and pain symptoms during postoperative stability,which has relative safety.