有颞下颌关节紊乱症状的成年女性关节盘改变与下颌骨形态的相关性研究

doi:10.13591/j.cnki.kqyx.2026.01.008

摘要/Abstract

摘要：

目的分析颞下颌关节盘形态、位置与下颌骨垂直向和矢状向形态的关系。方法选择因颞下颌关节紊乱综合征(temporomandibular disorders,TMD)就诊于四川大学华西口腔医院颞下颌关节科的223例成年女性患者。根据核磁共振影像(magnetic resonance imaging, MRI)将关节盘位置分为盘髁关系正常、可复性盘前移(disc displacement with reduction, DDwR)和不可复性盘前移(disc displacement without reduction, DDwoR) 3组,关节盘形态分为基本正常和异常两组。根据头颅侧位片测量下颌骨垂直向(下颌平面角、Y轴角、下颌支高度)和矢状向(SNB、下颌体长度、鞍角)形态指标。比较各个测量指标与关节盘位置、形态的相关性。结果关节盘位置和形态与下颌平面角、下颌支高度和Y轴角之间具有相关性(P<0.05),左侧关节盘位置与SNB之间具有相关性(P<0.05),双侧关节盘形态与SNB之间具有相关性(P<0.05)。结论关节盘的形态和位置与下颌骨的垂直向和矢状向形态之间有相关性,与垂直向形态之间的相关性更加密切。

关键词: 颞下颌关节紊乱综合征, 核磁共振, 头影测量, 关节盘位置, 下颌骨形态

Abstract:

Objective To analyze the relationship between the morphology and position of the temporomandibular joint disc and the vertical and sagittal morphology of the mandible. Methods A group of adult female patients with temporomandibular disorders were selected in the Department of Temporomandibular joint at West China Stomatological Hospital, Sichuan University. They were classified into normal position, disc displacement with reduction (DDwR), and disc displacement without reduction (DDwoR). The total number of patients included in this study was 223. The morphology of the disc was classified into normal and abnormal groups. Vertical (mandibular plane angle, Y-axis angle, ramus height) and sagittal (SNB, mandibular body length, saddle angle) morphological indicators of the mandible were measured on the lateral cephalometric radiographs. The correlation between the indicators and the morphology and position of the disc was compared. Results It showed that there was a correlation between the position and morphology of the disc and mandibular plane angle, Y-axis angle and ramus height (P<0.05), a correlation between the position of the left disc and SNB (P<0.05), and a correlation between the morphology of the bilateral disc and SNB (P<0.05). Conclusion There is a correlation between the morphology and position of the disc and the vertical and sagittal mandibular morphology, with a closer correlation with the vertical shape.

Key words: temporomandibular disorders, magnetic resonance imaging, cephalometry, disc position, mandibular morphology

中图分类号:

R782.6

殷晓丽, 刘洋. 有颞下颌关节紊乱症状的成年女性关节盘改变与下颌骨形态的相关性研究[J]. 口腔医学, 2026, 46(1): 48-53.

YIN Xiaoli, LIU Yang. Correlation between the changes of articular disc and mandibular morphology in adult women with temporomandibular disorders symptoms[J]. Stomatology, 2026, 46(1): 48-53.

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	测量项目		组别			F	P
	测量项目		正常	DDwR	DDwoR	F	P
垂直向	FMA	R	24.47±5.88	24.71±5.76	28.24±6.84	9.32	0.000^**
	FMA	L	23.83±5.92	25.48±5.57	28.64±7.03	11.38	0.000^**
	Y轴角	R	62.11±3.41	61.55±3.65	63.08±3.91	3.10	0.047^*
	Y轴角	L	61.70±3.44	61.87±3.59	63.52±3.84	5.74	0.004^**
	Ar-Go	R	46.50±4.41	44.82±3.75	43.77±4.13	9.45	0.000^**
	Ar-Go	L	46.88±4.20	45.24±4.04	43.14±3.95	15.67	0.000^**
矢状向	SNB	R	77.75±3.60	77.65±3.06	76.60±3.91	2.56	0.080
	SNB	L	77.69±3.57	77.88±3.53	76.24±3.67	4.74	0.010^*
	Na-S-Ar	R	127.36±5.51	125.81±3.97	126.05±5.26	1.99	0.139
	Na-S-Ar	L	127.69±5.09	125.98±4.63	125.92±5.54	2.78	0.064
	Go-Me	R	67.16±4.53	67.61±3.94	65.83±5.52	2.70	0.070
	Go-Me	L	67.16±4.82	66.78±4.00	66.24±5.70	0.66	0.521

测量项目		P
测量项目		正常-DDwR	正常-DDwoR	DDwR-DDwoR
FMA	R	0.831	0.000^**	0.002^**
FMA	L	0.111	0.000^**	0.002^**
Y轴角	R	0.403	0.082	0.021^*
Y轴角	L	0.787	0.003^**	0.005^**
Ar-Go	R	0.027^*	0.000^**	0.159
Ar-Go	L	0.016^*	0.000^**	0.001^**
SNB	R	-	-	-
SNB	L	0.751	0.016^*	0.005^**

测量项目			组别		F	P
测量项目			基本正常	异常	F	P
垂直向	FMA	R	24.76±5.59	27.58±7.15	10.92	0.001^**
	FMA	L	24.33±5.72	28.27±6.78	22.17	0.000^**
	Y轴角	R	62.05±3.40	63.28±4.02	6.16	0.018^*
	Y轴角	L	61.69±3.48	63.27±3.81	10.34	0.001^**
	Ar-Go	R	46.02±4.20	43.87±4.19	14.54	0.000^**
	Ar-Go	L	46.36±4.14	43.32±3.95	30.68	0.000^**
矢状向	SNB	R	77.80±3.40	76.62±3.84	5.90	0.016^*
	SNB	L	77.82±3.56	76.54±3.66	6.91	0.009^**
	Na-S-Ar	R	126.71±5.13	126.24±5.16	0.45	0.504
	Na-S-Ar	L	127.07±4.96	125.76±5.28	3.59	0.059
	Go-Me	R	67.26±4.40	66.08±5.35	3.27	0.072
	Go-Me	L	67.27±4.44	66.00±5.35	3.76	0.054