恒牙列安氏Ⅰ、Ⅱ~1、Ⅱ~2、Ⅲ类颞下颌关节骨性结构的锥形束CT比较

Comparison of skeletal structure of temporomandibular joint through cone-beam CT between Angle ClassⅠ, Ⅱ~1,Ⅱ~2, Ⅲ malocclusion patients with permanent dentition

目的:研究不同性别和安氏Ⅰ、Ⅱ1、Ⅱ2、Ⅲ类之间颞下颌关节及其周围相关骨性结构的差异。方法:对123例不同安氏分类错?畸形患者拍摄锥形束CT(CBCT),使用Mimics19.0软件进行三维重建,在矢状面上对颞下颌关节的前间隙、上间隙、后间隙、关节窝宽度、关节窝深度、髁突高度、髁突水平角、髁突半径、髁突前后径以及髁突长轴径进行测量分析,对髁突在关节窝的位置采用Pullinger法进行分析。采用SPSS 22.0软件包对数据进行统计学处理。结果:安氏Ⅰ类、Ⅱ1类、Ⅱ2类及Ⅲ类患者中,男性双侧髁突相关骨性结构均显著大于女性,Ⅱ1类患者髁突长轴径、前后径相对其他类型较小,Ⅲ类骨性患者的关节窝具有宽和浅的特征。安氏Ⅰ类、Ⅱ1类及Ⅲ类患者髁突在关节窝的位置主要为前位或居中,而Ⅱ2类主要为居中或后移位。不同安氏分类法的左右侧髁突相关结构无显著差异(P>0.05)。结论:不同安氏分类法中,错?畸形患者的颞下颌关节在髁突形态与结构、关节间隙、关节窝形态及髁突位置等方面存在显著差异。

PURPOSE:To compare characteristics of temporomandibular joint and related structures according to gender and AngleⅠ,Ⅱ1,Ⅱ2 andⅢclass.METHODS:Cone-beam CT(CBCT)was performed in 123 patients with malocclusion,and three-dimensional reconstruction was performed with Mimics 19.0 software.The anterior,upper,and posterior spaces of temporomandibular joint,width and depth of acetabulum,height and horizontal angle of condyle,radius of condyle,and anteroposterior and long-axis diameter of condyle were analysed on sagittal plane.The position of condyle in the joint fossa was analyzed using Pullinger methods.SPSS 22.0 software package was used for statistical analysis.RESULTS:Significant differences were found in the long axis and radius of the condyles between ClassⅠandⅢ,ClassⅠandⅡ1,respectively(P<0.05).The widest acetabulum was observed in ClassⅢ,followed by ClassⅠ,Ⅱ1,andⅡ2.Moreover,the deepest acetabulum was found in ClassⅡ2,followed by ClassⅡ1,Ⅰ,andⅢ.No significant differences were detected in the left and right condyle-related structures among different temporomandibular articulation.In addition,the anterior articular space was significantly larger in ClassⅠpatients,compared with ClassⅡ2 patients.CONCLUSIONS:There are significant differences in condylar morphology,joint space,joint fossa morphology and condylar position between different Angle classifications.