Dolphin软件分析自锁托槽矫治青少年安氏Ⅱ类1分类错颌患者颞下颌关节的变化

Changes of temporomandibular joint in adolescent patients with ClassⅡ,Category 1 malocclusion treated with self-ligating brackets analyzed by Dolphin software

目的探讨应用Dolphin软件分析自锁托槽矫治青少年安氏Ⅱ类1分类错颌患者颞下颌关节的变化。方法选取2020年12月至2022年3月中国人民解放军陆军第七十三集团军医院口腔科就诊的110例青少年安氏Ⅱ类1分类错颌患者作为研究对象进行回顾性研究,其中男48例,女62例,年龄(12.21±1.02)岁。所有患者均采用自锁托槽矫治器矫正治疗,矫正前后拍摄大视野锥形束CT(CBCT),导入Dolphin软件进行定点测量,分析患者矫正前、矫正两年后颞下颌关节变化情况。采用配对t检验。结果矫正后,轴状面的左侧髁突内外径(16.42±0.43)mm、右侧髁突内外径(16.10±0.88)mm、左侧前后径(8.62±0.80)mm、右侧前后径(8.96±1.19)mm、左侧颞下颌关节半径(49.36±1.25)mm、右侧颞下颌关节半径(49.06±1.20)mm、左侧髁突高度(3.44±0.23)mm、右侧髁突高度(3.85±0.30)mm均大于矫正前(t=2.151、2.350、6.914、3.250、2.393、2.188、1.984、9.354,均P<0.05);矫正后,矢状位的左侧关节前间隙(2.30±0.41)mm、右侧关节前间隙(2.54±0.52)mm、左侧关节上间隙(2.89±0.50)mm、右侧关节上间隙(3.04±1.02)mm、左侧关节后间隙(2.58±0.49)mm、右侧关节后间隙(2.46±0.53)mm、左侧髁突宽(9.06±0.99)mm、右侧髁突宽(10.06±1.36)mm均大于矫正前(t=2.231、3.635、1.996、2.281、19.761、17.790、2.076、3.286,均P<0.05);矫正后,冠状位的左侧关节内间隙(2.86±0.78)mm、右侧关节内间隙(2.77±0.63)mm、左侧关节上间隙(3.04±0.52)mm、右侧关节上间隙(3.30±0.98)mm、左侧关节外间隙(3.64±1.00)mm、右侧关节外间隙(3.88±1.15)mm、左侧髁突宽(15.00±0.82)mm,右侧髁突宽(15.12±0.99)mm均大于矫正前(t=2.101、2.183、6.097、5.189、2.073、2.292、3.020、2.639,均P<0.05)。结论经Dolphin软件分析,青少年安氏Ⅱ类1分类错颌患者采用自锁式托槽式矫治器治疗,颞下颌关节参数发生一定变化。

Objective To explore the application of Dolphin software to analyze the changes of temporomandibular joint(TMJ)in the treatment of adolescent patients with ClassⅡ,Category 1 malocclusion treated with self-ligating brackets.Methods A retrospective study was carried out on 110 adolescent patients with ClassⅡ,Category 1 malocclusion in the Department of Stomatology of the 73rd Group Army Hospital of the Chinese People's Liberation Army from December 2020 to March 2022.There were 48 males and 62 females,with an age of(12.21±1.02)years old.All the patients were treated with self-ligating bracket appliance.Large field cone beam computed tomography(CBCT)was taken before and after correction,and Dolphin software was introduced for fixed-point measurement.The changes of TMJ before and 2 years after correction were analyzed.Paired t test was used.Results After correction,the left condylar internal and external diameter[(16.42±0.43)mm],right condylar internal and external diameter[(16.10±0.88)mm],left anteroposterior diameter[(8.62±0.80)mm],right anteroposterior diameter[(8.96±1.19)mm],left TMJ radius[(49.36±1.25)mm],right TMJ radius[(49.06±1.20)mm],left condylar height[(3.44±0.23)mm],and right condylar height[(3.85±0.30)mm]at the axial plane were higher than those before correction(t=2.151,2.350,6.914,3.250,2.393,2.188,1.984,and 9.354;all P<0.05).After correction,the left anterior joint space[(2.30±0.41)mm],right anterior joint space[(2.54±0.52)mm],left superior joint space[(2.89±0.50)mm],right superior joint space[(3.04±1.02)mm],left posterior joint space[(2.58±0.49)mm],right posterior joint space[(2.46±0.53)mm],left condylar width[(9.06±0.99)mm],and right condylar width[(10.06±1.36)mm]in the sagittal position were all greater than those before correction(t=2.231,3.635,1.996,2.281,19.761,17.790,2.076,and 3.286;all P<0.05).After correction,the left intra-articular space[(2.86±0.78)mm],right intra-articular space[(2.77±0.63)mm],left superior articular space[(3.04±0.52)mm],right superior articular space[(3.30±0.98)mm],left external articular space[(3.64±1.00)mm],right external articular space[(3.88±1.15)mm],left condylar width[(15.00±0.82)mm],and right condylar width[(15.12±0.99)mm]in the coronal position were all greater than those before correction(t=2.101,2.183,6.097,5.189,2.073,2.292,3.020,and 2.639;all P<0.05).Conclusion According to Dolphin software analysis,the TMJ parameters change to a certain extent after the self-ligating bracket appliance is used for the treatment of adolescent patients with ClassⅡ,Category 1 malocclusion.