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论文摘要

颞下颌关节盘前移位患者关节骨形态与矢状向关节盘位置的关系

Association between bone morphology and sagittal disc position in temporomandibular joints of patients with anterior disc displacement

作者:鄢梨, 周茂强, 邱嘉旋

Author:Yan Li, Zhou Maoqiang, Qiu Jiaxuan

收稿日期:2022-01-24          年卷(期)页码:2022,40(4):414-414-421

期刊名称:华西口腔医学杂志

Journal Name:West China Journal of Stomatology

关键字:颞下颌关节,关节盘前移位,锥形束CT,磁共振成像,矢状向,形态学测量,

Key words:temporomandibular joint,anterior disc displacement,cone beam CT,magnetic resonance ima-ging,sagittal position,morphologic measurement,

基金项目:国家自然科学基金(81860477);江西省重点研发计划(20212BBG71005)

中文摘要

目的 利用磁共振成像(MRI)技术和锥形束CT(CBCT)分析颞下颌关节盘前移位患者矢状向关节盘位置与关节骨形态的关系。方法 对97例患者的178个颞下颌关节(TMJ)进行回顾性分析,根据矢状向MRI上关节盘的位置分成4组,即对照组(关节盘无移位)、轻度组(关节盘轻度前移位)、中度组(关节盘中度前移位)和重度组(关节盘重度前移位)。然后利用Mimics 20软件基于CBCT数据进行TMJ的相关形态学参数测量,包括髁突线性尺寸(宽度、长度和高度)、髁突体积和表面积,关节窝的深度和长度,关节结节倾斜角,关节前、上、后间隙等,并对各组矢状髁突位置进行评估。使用方差分析、非参数检验和卡方检验等比较关节形态及位置参数的组间差异,采用相关性分析探索矢状关节盘位置与关节测量参数之间的相关性。结果 髁突的线性尺寸、关节窝深度、关节倾斜角、关节间隙和矢状髁突位置分布在4组间差异有统计学意义,而关节窝长度在4组间差异没有统计学意义;相关性分析显示:髁突的线性尺寸、髁突的体积及表面积、关节窝的深度、关节结节倾斜角和关节上间隙与关节盘矢状位置之间存在显著负相关,而关节后间隙与矢状关节盘位置之间存在显著正相关。结论 TMJ骨形态与不同矢状关节盘位置之间存在相关性,应警惕临床看到的关节骨形态的退行性改变可能是患者存在关节盘前移位的标志。

英文摘要

ObjectiveTo analyze the association between sagittal temporomandibular joint (TMJ) disc position of patients with anterior disc displacement evaluated by magnetic resonance imaging (MRI) and bone morphology of the TMJ evaluated by cone-beam computed tomography (CBCT).MethodsOne hundred and seventy-eight TMJs of 97 patients were retrospectively analyzed. The TMJ disc position was evaluated using MRI and classified into four types: control group (without disc displacement), slight group (disc slightly anteriorly displaced), moderate group (disc moderately anteriorly displaced), and severe group (disc severely anteriorly displaced). The measurements of TMJ bone morphology among four groups were evaluated by CBCT through Mimics software including condyle linear dimensions (condyle length, width, and height), condylar volume and surface area, and the depth and length of the glenoid fossa, joint anterior space, joint superior space, and joint posterior space. The sagittal plane position of the condyle was also assessed. The differences in all the morphologic measurement parameters among the four groups were detected using the one-way analysis of variance or the Kruskal Wallis test, and Chi-square tests. The correlations between disc sagittal position and all the morphologic measurements were also analyzed.ResultsThere were significant differences in measurements of condyle linear dimensions, condylar volume and surface area, depth of the glenoid fossa, joint spaces, and distribution of the condyle sagittal positions among the four groups. By contrast, there were no statistical differences in terms of the length of the glenoid fossa among the four groups. Correlation analysis revealed that there is a statistically significant negative correlation among condyle linear dimensions, condylar volume and surface area, the depth of the glenoid fossa, joint superior space, and disc position. However, joint posterior space was positively correlated with disc position.ConclusionA statistically significant correlation was determined between TMJ bone morphology and different sagittal disc positions. Degenerative changes in TMJ bone morphology clinically diagnosed should be altered, which can be the patients' marker of anterior disc displacement.

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