骨性Ⅰ类和骨性Ⅲ类错𬌗畸形患者的髁突-关节窝形态特征对比

doi:10.13591/j.cnki.kqyx.2023.06.008

摘要/Abstract

摘要：

目的研究骨性Ⅰ类错𬌗畸形、骨性Ⅲ类错𬌗伴上颌骨发育不足和骨性Ⅲ类错𬌗伴下颌骨发育过度患者之间的髁突-关节窝的形态差异。方法收集2021年3月至2022年12月于南京医科大学附属口腔医院正畸科就诊患者,其中包括骨性Ⅰ类错𬌗畸形、骨性Ⅲ类错𬌗伴上颌骨发育不足和骨性Ⅲ类错𬌗伴下颌骨发育过度患者共58例,行锥形束CT扫描,利用Mimics 20.0软件和Dolphin 11.9软件对髁突和关节窝的相关角度及线性指标进行测量评估,采用SPSS 26.0软件进行统计学分析。结果骨性Ⅰ类错𬌗畸形、骨性Ⅲ类错𬌗伴上颌骨发育不足和骨性Ⅲ类错𬌗伴下颌骨发育过度患者,每组患者的左侧和右侧的髁突和关节窝形态一致,差异无统计学意义(P>0.05);骨性Ⅲ类错𬌗伴上颌骨发育不足和骨性Ⅲ类错𬌗伴下颌骨发育过度患者均较骨性Ⅰ类错𬌗畸形患者的髁突上部高度增加(P<0.05);骨性Ⅲ类错𬌗伴下颌骨发育过度的患者较骨性Ⅰ类错𬌗畸形患者的关节结节后斜面的倾斜度和关节窝高度减小(P<0.05);骨性Ⅲ类错𬌗伴上颌骨发育不足和骨性Ⅲ类错𬌗伴下颌骨发育过度患者之间的各测量值差异均无统计学意义(P>0.05)。结论三组双侧颞下颌关节基本对称,差异无统计学意义;骨性Ⅰ类错𬌗畸形与骨性Ⅲ类错𬌗畸形在髁突上部高度、关节结节后斜面倾斜度和关节窝高度存在显著差异;但在骨性Ⅲ类错𬌗畸形中,上颌骨发育不足患者和下颌骨发育过度患者的颞下颌关节的髁突-关节窝形态特征虽有差异,但不具有统计学意义。

关键词: 髁突, 关节窝, 骨性Ⅲ类错𬌗畸形, 上颌骨发育不足, 下颌骨发育过度

Abstract:

Objective To study the morphological differences of condyle-fossa in people with skeletal Class Ⅰ malocclusion and skeletal Class Ⅲ malocclusion who were divided into maxillary deficiency and mandibular prognathism. Methods The CBCT images of bilateral temporomandibular joint (TMJs) in 58 patients with skeletal Class Ⅰ and Ⅲ were selected, who were treated in the Department of Orthodontics, Affiliated Hospital of Stomatology Nanjing Medical University from March 2021 to December 2022. Relative angular and linear measurements of the condyle-fossa were conducted with Mimics 20.0 and Dolphin 11.9 software. The data was analyzed with SPSS 26.0 software. Results There was no statistical difference in the measurement items of TMJs between the left and right sides(P<0.05)in patients with skeletal Class Ⅰ and Ⅲ malocclusion. The condyle height of both skeletal Class Ⅲ malocclusion was higher than the skeletal Class Ⅰ malocclusion(P<0.05). In addition, the comparisons of the skeletal Class Ⅲ malocclusion with mandibular prognathism and the skeletal Class Ⅰ malocclusion showed statistical differences in the articular eminence inclination and the height of the glenoid fossa(P<0.05). However, the intergroup comparisons of the skeletal Class Ⅲ malocclusion showed no statistical differences in all morphological measurements(P>0.05). Conclusion There was no obvious difference between bilateral temporomandibular joints among the three groups. Significant differences were shown between skeletal Class Ⅰ and Ⅲ malocclusion in terms of condylar height, the central joint space, the articular eminence inclination, and the height of the glenoid fossa. While there were differences in the morphological measurements of TMJs among patients with maxillary deficiency and mandibular prognathism of skeletal Class Ⅲ malocclusion, these disparities did not have statistical significance.

Key words: condylar, glenoid fossa, skeletal Class Ⅲ malocclusion, maxillary deficiency, mandibular prognathism

中图分类号:

R783.5

张程程, 周浠, 范力文, 马兰, 潘永初. 骨性Ⅰ类和骨性Ⅲ类错𬌗畸形患者的髁突-关节窝形态特征对比[J]. 口腔医学, 2023, 43(6): 524-528.

ZHANG Chengcheng, ZHOU Xi, FAN Liwen, MA Lan, PAN Yongchu. A comparative study on morphological characteristics of condyle-fossa for skeletal Class Ⅰ and Ⅲ malocclusion[J]. Stomatology, 2023, 43(6): 524-528.

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测量指标	骨性Ⅰ类			上颌骨发育不足			下颌骨发育过度
测量指标	左侧	右侧	P^*	左侧	右侧	P^*	左侧	右侧	P^*
髁突上部高度/mm	5.12±1.11	5.01±0.87	0.463	6.32±1.87	6.52±1.64	0.556	6.32±1.13	6.60±1.63	0.235
髁突内外嵴/mm	18.02±1.74	18.45±2.25	0.308	18.07±2.24	18.21±2.39	0.640	18.14±1.85	18.52±2.01	0.214
髁突前后嵴/mm	7.55±0.84	7.54±0.81	0.965	7.05±1.17	7.29±1.15	0.247	7.51±1.03	7.39±1.03	0.618
关节结节后斜面倾斜度/(°)	36.86±5.27	35.68±6.17	0.454	32.96±6.82	34.97±11.87	0.350	31.75±7.92	30.79±7.04	0.561
关节窝高度/mm	7.40±0.97	7.42±0.94	0.934	7.01±1.01	7.08±1.11	0.704	6.79±1.61	6.74±1.34	0.839
关节窝宽度/mm	19.49±1.61	19.84±1.28	0.288	20.0±2.34	19.59±2.50	0.245	20.84±2.41	20.46±2.22	0.422

测量指标	骨性Ⅰ类			上颌骨发育不足			下颌骨发育过度
测量指标	左侧	右侧	P^*	左侧	右侧	P^*	左侧	右侧	P^*
关节上间隙/mm	4.98 (4.30~5.28)	3.55 (3.39~4.09)	0.478	4.02 (3.35~4.87)	3.28 (2.66~3.82)	0.177	3.91 (3.20~4.74)	3.56 (2.74 ~ 4.14)	0.911
关节前间隙/mm	3.76 (3.36~4.39)	4.81 (4.51~5.15)	0.067	3.76 (3.26~4.20)	4.22 (3.59~5.57)	0.240	3.73 (3.22~4.50)	4.12 (3.31~ 4.49)	0.573
关节后间隙/mm	3.26 (3.09~3.84)	3.62 (3.16~4.09)	0.232	3.32 (2.76~4.61)	3.64 (3.03~4.05)	0.297	3.88 (2.98 ~ 4.17)	3.86 (3.42~ 4.02)	0.940

测量指标	骨性Ⅰ类	上颌骨发育不足	下颌骨发育过度	P1	P2	P3
髁突上部高度/mm	5.07± 0.99	6.42±1.74	6.47±1.40	0.000^*	0.000^*	0.999
关节前间隙/mm	3.63±0.66	3.58±1.22	3.61±0.86	0.790	0.870	0.920
关节后间隙/mm	3.71±0.66	3.62±0.72	3.81±0.64	0.564	0.528	0.235
髁突内外嵴/mm	18.24±2.00	18.14±2.38	18.33±1.92	0.842	0.840	0.692
髁突前后嵴/mm	7.54±0.81	7.17±1.15	7.45±1.02	0.106	0.674	0.226
关节窝高度/mm	7.41±0.95	7.04±1.05	6.76±1.46	0.175	0.016^*	0.307

测量指标	骨性Ⅰ类	上颌骨发育不足	下颌骨发育过度	P
关节上间隙/mm	3.47(3.19~4.01)	3.32(2.73~4.12)	3.645(2.92~4.14)	0.505
关节结节后斜面倾斜度/(°)	36.60(32.53~40.06)	32.68(27.32~37.26)	31.19(26.05~36.23)	0.004^**
关节窝宽度/mm	19.79(18.94~20.83)	19.78(17.50~21.64)	20.15(19.07~21.72)	0.183