单侧有症状的颞下颌关节紊乱病患者双侧关节锥形束CT对比研究

›› 2016, Vol. 36 ›› Issue (1): 40-43.

单侧有症状的颞下颌关节紊乱病患者双侧关节锥形束CT对比研究

李岩峰¹,郭晓倩²,苏　宏³,吕源¹,张建强¹,王宁¹,孙鹏⁴,曹静¹,王照五⁵,胡敏⁵,刘洪臣⁵

1. 解放军总医院第一附属医院
2. 宁夏医科大学总医院口腔科
3. 辽宁省武警总队
4. 解放军总医院第一附属医院口腔科
5. 解放军总医院

收稿日期:2015-06-01 修回日期:2015-08-20 出版日期:2016-01-28 发布日期:2016-01-08
通讯作者: 李岩峰 E-mail:m.god@yeah.net

Comparative study on bilateral temporomandibular joint of patients with unilateral symptoms in cone-beam computed tomography

Received:2015-06-01 Revised:2015-08-20 Online:2016-01-28 Published:2016-01-08

摘要/Abstract

摘要： 目的探讨单侧有症状的颞下颌关节紊乱病患者双侧颞下颌关节在CBCT成像上可能存在差异的参考层面，为颞下颌关节紊乱病诊断和对比研究提供参考。方法选取一侧TMJ有症状的TMD患者87例，通过CBCT三维成像和重建，观察同一患者两侧TMJ重建后横断面的水平角；平行于髁突长轴的斜位关节间隙、髁突长轴径值、髁突垂直角；垂直于髁突长轴的斜位与矢状位的关节结节斜度、和关节间隙,采用SPSS13.0 软件包对每位患者上述各测量指标做两配对样本t检验。结果两侧TMJ在平行位120°、矢状位60°和90°、垂直位60°和120°时的关节间隙测量值差异均有统计学意义（P＜0.05），其中矢状位90°关节间隙的差异更显著（P＜0.01），其余值均无统计学差异。结论对于单侧有症状的TMD患者，矢状位或垂直位是较易观察到左右两侧有差异的位置，在垂直位和矢状位均观察到前间隙的增大，在这个层面重建对诊断和对比研究更有意义。

关键词: 单侧, 颞下颌关节紊乱病, 颞下颌关节, 锥形束CT, 对比研究

Abstract: Objective To investigate bilateral temporomandibular joint of patients with unilateral symptoms in cone-beam computed tomography and research the refrence planes that may be different,providing refernce for the diagnosis of temporomandibular disorders and comparative study. Methods 87 cases with unilateral symptoms were examined by CBCT and the following indexes were observed and analyzed,including horizontal angles of the cross-sectional condyle after the reconstruction in the same patient、the joint space、the macroaxis diameter of condyle and vertical angles of condyle, which were commonly used at oblique position parallelled to the long axis of condyle、the gradient of articular tubercle and the joint space,which could be obtained at sagittal and oblique position vertical to the long axis of condyle.The data obtained was analyzed by paired t tests with SPSS13.0 software package.Results It was shown that there were significant difference between the bilateral measured value of joint space when the angle was 120°in parallel plane、60°and 90°in sagittal plane、60°and 120°in vertical plane(P < 0.05).The diffenrence was more significant when the angle was 90°in sagittal plane(P < 0.01), the other ones were no significant difference. Conclusion To patients with TMD, it is more easily to observe differences between the bilateral measured value of joint space in the sagittal or vertical plane,where the increase of the front joint space can be seen and the construction was more significant for the diagnosis of temporomandibular disorders and comparative study.

Key words: bilateral, temporomandibular disorders，TMD , temporomandibular joint, cone-beam computed tomography,CBCT, comparative study

李岩峰郭晓倩苏　宏吕源张建强王宁孙鹏曹静王照五胡敏刘洪臣. 单侧有症状的颞下颌关节紊乱病患者双侧关节锥形束CT对比研究[J]. , 2016, 36(1): 40-43.

参考文献

[1]Lipton JA,ShipJA,Larach-Robinson D.Estimated prevalence and distribution of reported orofacial pain in the United States[J].J Am Dent Assoc,1993,124(10):115-21 [2]李岩峰，郭晓倩，陈燕，等.利用CBCT行双侧颞下颌关节对比测量的技术探讨.[J].中国医学物理学杂志,2014,31(2):4810-4813 [3]Pampel M,Jakstat HA,Ahlers OM.Impact of sound production by wind instruments on the temporomandibular system of male instrumentalists[J].,2014,48(1):27-35 [4]胡敏.从颞下颌关节骨性结构比较思考关节病变[J].杭州第九次全国颞下颌关节病学及(牙合)学研讨会论文汇编,2012,:13-14 [5]Chirani RA,Jacq JJ,Meriot P,et al.Temporomandibular joint:amethodology of magnetic resonance imaging 3-D reconstruction[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2004,97:756-761 [6]Pharaboz C,Carpentier P.MR imaging of Temopromandibular　joints[J].Radiol,2009,90(5 Pt 2):642-648 [7]Beer A,Kolk A,Neff A,et al.Cine MRI of the temporomandibular joint in comparison to static MRI and axiography[J].Rofo,2004,176:506-512 [8]McDavid WD,Tronje G,Welander U,et al.Dimensional reproduction in rotational panoramic radiography[J].Oral Surg Oral Med Oral Pathol,1986,62(2):96-101 [9]Tvrdy P.Methods of imaging in the diagnosis of temporomandibular joint disorders[J].Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub,2007,151(1):133-136 [10]Palomo JM,Kau CH,Palomo LB,et al.Three-dimensional cone beam computerized tomography in dentistry[J].Dent Today,2006,25(11):130- [11]Scarfe WC,Farman AG,Sukovic P.Clinical applications of cone-beam computed tomography in dental practice.[J].J Can Dent Assoc,2006,72(1):75-80 [12]Weiss E,Wu J,Sleeman W,et al.Clinical evaluation of soft t3 organ boundary visualization on cone －beam computed tomographic imaging[J].Int J Radiat Oncol Biol Phys,2010,78(3):929-936 [13]DeVos W,Casselman J,Swennen GR.Cone-beam computerized tomography（CBCT）imaging of the oral and maxillofacial region:a systematic review of the literature[J].Int J Oral Maxillofac Surg,2009,38(6):609-625 [14]石校伟,王照五,李亚男,等.颌面专用CT 下颌骨检查技术[J].中华老年口腔医学杂志,2006,4(3):170- [15]王照五,石校伟,姜华,等.牙颌专用CT的颞下颌成像技术[J].中国医学影像学杂志,2006,14:444- [16]OkurA,OzkirisM,Kapusuz Z,et al.Characteristics of articular fossa and condyle in patients with temporomandibularjointcomplaint[J].Eur Rev Med Pharmacol Sci,2012,16(15):2131-2135 [17]TsurutaA,YamadaK,Hanada K,et al.Thickness of the roof of the glenoid fossa and condylar bone change: a CT study[J].Dentomaxillofac Radiol,2003,32(4):217-221 [18]Yamada K,TsurutaA,HanadaK,etal.Morphologyof the articular eminence in temporomandibular joints and condylar bone change[J].J Oral Rehabil,2004,31(5):438-44 [19]赵燕平,马绪臣,傅开元,等.牙颌面专用CT 颞下颌关节造影的临床应用[J].中华口腔医学杂志,2003,38(5):321-323 [20]孟凡文,胡开进,周树夏,等.多排螺旋CT 在颞下颌关节形态研究中的应用[J].实用放射学杂志,2006,22(11):1308-1311 [21]李岩峰,吕源,郭晓倩,等.单侧弹响的颞下颌关节紊乱病患者双侧关节锥形束CT对比研究.[J].口腔颌面修复学杂志,2015,16(1):24-26