功能受限型颞下颌关节紊乱病的智能动态评估方法研究

Intelligent dynamic assessment methods in functionally limited temporomandibular disorders

目的:探索一种客观简便的能对功能受限型颞下颌关节紊乱病(temporomandibular disorders,TMD)颞下颌关节的运动模式进行评估的方法。方法:选取2020年1月—2022年7月就诊于潮州市人民医院的44例功能受限型TMD患者作为研究组,其中男性24例,女性20例,年龄12~68(29.6±14.8)岁。同期招募37名正常志愿者作为对照组,其中男性29名,女性8名,年龄13~70(34.1±16.3)岁。在研究对象鼻唇沟中点及颏唇沟中点凹陷处粘贴白色标志点,利用自行设计的图像采集装置录取研究对象颞下颌关节运动的动态图像数据,通过自行开发的配套软件对预先标记的标志点进行自动识别、提取研究对象颞下颌关节运动的最大偏移距离、最大偏离角度等指标。结果:采用自动检测方法测得研究组的最大偏移距离[(3.81±0.25)mm]大于对照组[(2.48±0.18)mm],差值为1.33 mm(95%CI:0.70~1.96 mm),差异有统计学意义(t=4.209,P<0.001)。研究组的最大偏移角度[(15.09±1.13)°]大于对照组[(8.85±0.78)°],差值为6.24°(95%CI:3.40°~9.08°),差异有统计学意义(t=4.376,P<0.001)。结论:自动检测方法能够识别出颞下颌关节运动的最大偏移距离和最大偏移角度,能为功能受限型TMD的评估提供更客观的指标。

Objective:To explore an objective and simple method to assess the movement patterns of the temporomandibular joints(TMJ)in functionally limited temporomandibular disorders(TMD).Methods:Forty-four patients with functionally limited TMD who attended Chaozhou Peoples Hospital from January 2020 to July 2022 were selected as the study group,including 24 males and 20 females,aged 12-68(29.6±14.8)years.Thirty-seven normal volunteers were recruited as the control group in the same period,including 29 males and 8 females,aged 13-70(34.1±16.3)years.White marker dots were pasted on the midpoint of the nasolabial groove and the depression of the midpoint of the chin-labial groove of the study subjects,and the dynamic image data of the TMJ movements of the study subjects were recorded by using a self-designed image acquisition device,and the pre-marked marking points were automatically identified and the maximum offset distance and maximum deviation angle of the TMJ movements of the study subjects were extracted by the self-developed supporting software.Results:The maximum offset distance[(3.81±0.25)mm]in the study group was greater than that in the control group[(2.48±0.18)mm],with a difference of 1.33 mm(95%CI:0.70-1.96 mm),measured using the automated method,with a statistically significant difference(t=4.209,P<0.001).The maximum offset angle in the study group[(15.09±1.13)°]was greater than that in the control group[(8.85±0.78)°],with a difference of 6.24°(95%CI:3.40°-9.08°),which was statistically significant(t=4.376,P<0.001).Conclusion:The automated detection method can identify the maximum offset distance and maximum offset angle of TMJ movements and can provide a more objective index for the assessment of functionally limited TMD.