颞下颌关节紊乱综合征伴偏侧咀嚼患者锥形束CT特征分析

Cone beam CT imaging findings in patients with temporomandibular joint disorder syndrome and unilateral chewing

目的:分析颞下颌关节紊乱综合征(TMD)伴偏侧咀嚼患者的锥形束CT(CBCT)特征。方法:选择TMD伴偏侧咀嚼患者80例为实验组,另选健康志愿者40名为对照组。2组患者均行双侧CBCT扫描,获得三维图像,测量并比较2组患者的颞下颌关节(TMJ)参数。采用SPSS 22.0软件包对数据进行统计学分析。结果:对照组双侧TMJ参数无显著差异(P>0.05)。实验组偏侧咀嚼侧的髁突内外径显著低于非偏侧咀嚼侧,髁突水平角、髁突高度显著高于非偏侧咀嚼侧(P<0.05)。实验组偏侧咀嚼侧的髁突前后径、髁突内外径、髁突水平角、髁突垂直角和关节内间隙、关节后间隙显著低于对照组,而关节前间隙显著高于对照组(P<0.05);非偏侧咀嚼侧的髁突前后径、关节后间隙显著低于对照组,髁突内外径显著高于偏侧咀嚼侧,髁突高度显著低于偏侧咀嚼侧(P<0.05)。结论:TMD伴偏侧咀嚼患者存在双侧TMJ结构异常,偏侧咀嚼侧髁突内后移位和非偏侧咀嚼侧关节前间隙代偿性增大。

PURPOSE:To analyze the cone beam CT(CBCT) features in patients with temporomandibular disorder syndrome(TMD) and unilateral chewing.METHODS:A total of 80 patients with temporomandibular disorder syndrome(TMD) and unilateral chewing were selected as the experimental group,and 40 healthy volunteers were selected as the control group.Both groups underwent bilateral CBCT scans to obtain three-dimensional images,and the temporomandibu-lar joint(TMJ) parameters were measured and compared between the two groups.The data were analyzed performed using SPSS 22.0 software package.RESULTS:There was no significant difference in bilateral TMJ parameters in the control group(P>0.05).The inner and outer diameter of the condyle on the unilateral chewing side of the experimental group was significantly lower than that on the non-unilateral chewing side,and the condyle horizontal angle and condyle height were significantly higher than those on the non-unilateral chewing side(P<0.05).The anteroposterior diameter of the condyle,the inner and outer diameter of the condyle,the horizontal angle of the condyle,the vertical angle of the condyle,the intra-articular space and the post-articular space of the experimental group were significantly lower than those of the control group,while the pre-articular space was significantly higher than that of the control group(P<0.05).The anteroposterior diameter and retro-articular space of the condyle on the non-unilateral chewing side were significantly lower than those in the control group,and the inner and outer diameters of the condyle were significantly higher than those on the unilateral chewing side,and the height of the condyle was significantly lower than that on the unilateral chewing side(P <0.05).CONCLUSIONS:Patients with TMD syndrome and unilateral chewing have abnormal changes in bilateral TMJ structure,showing medial and posterior displacement of the condyle on the unilateral chewing side and a compensatory increase in the pre-articular space on the non-unilateral chewing side.