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

Abstract

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

CLC Number:

R782.6

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.

Figures/Tables 8

Tab.1

Fig.1

Fig.2

Fig.3

Tab.2

Tab.3

Tab.4

Tab.5

References 37

[1]	Ohrbach R, Dworkin SF. The evolution of TMD diagnosis: Past, present, future[J]. J Dent Res, 2016, 95(10): 1093-1101. doi: 10.1177/0022034516653922
[2]	Weinberg LA. The role of stress, occlusion, and condyle position in TMJ dysfunction-pain[J]. J Prosthet Dent, 1983, 49(4): 532-545. pmid: 6573501
[3]	Slade GD, Bair E, Greenspan JD, et al. Signs and symptoms of first-onset TMD and sociodemographic predictors of its development: The OPPERA prospective cohort study[J]. J Pain, 2013, 14(12 Suppl): T20-32.e1-3. doi: 10.1016/j.jpain.2013.07.014
[4]	Davant TS 6th, Greene CS, Perry HT, et al. A quantitative computer-assisted analysis of disc displacement in patients with internal derangement using sagittal view magnetic resonance imaging[J]. J Oral Maxillofac Surg, 1993, 51(9): 974-979;discussion 979-981. doi: 10.1016/S0278-2391(10)80038-2
[5]	Haiter-Neto F, Hollender L, Barclay P, et al. Disk position and the bilaminar zone of the temporomandibular joint in asymptomatic young individuals by magnetic resonance imaging[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2002, 94(3): 372-378. doi: 10.1067/moe.2002.127086
[6]	Katzberg RW, Westesson PL, Tallents RH, et al. Anatomic disorders of the temporomandibular joint disc in asymptomatic subjects[J]. J Oral Maxillofac Surg, 1996, 54(2): 147-153;discussion 153-155. doi: 10.1016/S0278-2391(96)90436-X
[7]	Tasaki MM, Westesson PL, Isberg AM, et al. Classification and prevalence of temporomandibular joint disk displacement in patients and symptom-free volunteers[J]. Am J Orthod Dentofacial Orthop, 1996, 109(3): 249-262. doi: 10.1016/S0889-5406(96)70148-8
[8]	Paknahad M, Shahidi S, Akhlaghian M, et al. Is mandibular Fossa morphology and articular eminence inclination associated with temporomandibular dysfunction[J]. J Dent (Shiraz), 2016, 17(2): 134-141.
[9]	Gökalp H. Disc position in clinically asymptomatic, pretreatment adolescents with Class Ⅰ, Ⅱ, or Ⅲ malocclusion[J]. J Orofac Orthop / Fortschr Der Kieferorthopädie, 2016, 77(3): 194-202. doi: 10.1007/s00056-016-0024-6
[10]	Kristensen KD, Schmidt B, Stoustrup P, et al. Idiopathic condylar resorptions: 3-dimensional condylar bony deformation, signs and symptoms[J]. Am J Orthod Dentofac Orthop, 2017, 152(2): 214-223. doi: 10.1016/j.ajodo.2016.12.020
[11]	Paknahad M, Shahidi S, Abbaszade H. Correlation between condylar position and different sagittal skeletal facial types[J]. J Orofac Orthop/Fortschr Der Kieferorthopädie, 2016, 77(5): 350-356.
[12]	Shu C, Xiong X, Huang LW, et al. The relation of cephalometric features to internal derangements of the temporomandibular joint: A systematic review and meta-analysis of observational studies[J]. Orthod Craniofac Res, 2021, 24(3): 305-313. doi: 10.1111/ocr.12454 pmid: 33290631
[13]	Shi JJ, Zhang F, Zhou YQ, et al. The relationship between partial disc displacement and mandibular dysplasia in female adolescents[J]. Med Sci Monit, 2010, 16(6): CR283-CR288.
[14]	刘加强, 吴勇, 孙良严, 等. 颌骨垂直向异常患者中颞下颌关节结构的情况分析[J]. 口腔颌面修复学杂志, 2015, 16(6): 335-338.
[15]	Jeon DM, Jung WS, Mah SJ, et al. The effects of TMJ symptoms on skeletal morphology in orthodontic patients with TMJ disc displacement[J]. Acta Odontol Scand, 2014, 72(8): 776-782. doi: 10.3109/00016357.2014.906650
[16]	Byun ES, Ahn SJ, Kim TW. Relationship between internal derangement of the temporomandibular joint and dentofacial morphology in women with anterior open bite[J]. Am J Orthod Dentofac Orthop, 2005, 128(1): 87-95. doi: 10.1016/j.ajodo.2004.01.028
[17]	Ioi H, Matsumoto R, Nishioka M, et al. Relationship of TMJ osteoarthritis/osteoarthrosis to head posture and dentofacial morphology[J]. Orthod Craniofac Res, 2008, 11(1): 8-16. doi: 10.1111/j.1601-6343.2008.00406.x pmid: 18199075
[18]	Cedströmer AL, Andlin-Sobocki A, Abbu N, et al. Condylar alterations and facial growth in children with juvenile idiopathic arthritis[J]. J Orofac Orthop / Fortschr Der Kieferorthopädie, 2020, 81(3): 163-171. doi: 10.1007/s00056-020-00216-8
[19]	Ahn SJ, Baek SH, Kim TW, et al. Discrimination of internal derangement of temporomandibular joint by lateral cephalometric analysis[J]. Am J Orthod Dentofac Orthop, 2006, 130(3): 331-339. doi: 10.1016/j.ajodo.2005.02.019
[20]	Taşkaya-Yilmaz N, Oğütcen-Toller M. Magnetic resonance imaging evaluation of temporomandibular joint disc deformities in relation to type of disc displacement[J]. J Oral Maxillofac Surg, 2001, 59(8): 860-865;discussion 865-866. doi: 10.1053/joms.2001.25016
[21]	Amaral RD, Damasceno NN, de Souza LA, et al. Magnetic resonance images of patients with temporomandibular disorders: Prevalence and correlation between disk morphology and displacement[J]. Eur J Radiol, 2013, 82(6): 990-994. doi: 10.1016/j.ejrad.2013.01.002 pmid: 23369857
[22]	马绪臣, 张震康. 颞下颌关节紊乱病双轴诊断的临床意义和规范治疗的必要性[J]. 中华口腔医学杂志, 2005, 40(5): 353-355.
[23]	Weedon S, Ahmed N, Sidebottom AJ. Prospective assessment of outcomes following disposable arthroscopy of the temporomandibular joint[J]. Br J Oral Maxillofac Surg, 2013, 51(7): 625-629. doi: 10.1016/j.bjoms.2013.06.004 pmid: 23886497
[24]	Incesu L, Taşkaya-Yilmaz N, Oğütcen-Toller M, et al. Relation-ship of condylar position to disc position and morphology[J]. Eur J Radiol, 2004, 51(3): 269-273. pmid: 15294336
[25]	Rabelo KA, Sousa Melo SL, Torres MGG, et al. Assessment of condyle position, Fossa morphology, and disk displacement in symptomatic patients[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2017, 124(2): 199-207. doi: 10.1016/j.oooo.2017.04.007
[26]	Suzuki K, Mito T, Ishizaki K, et al. Mandibular lateral translation during symmetric mandibular function in relation to patterns of intracapsular derangement of TMJ[J]. Int J Stomatol Occlusion Med, 2009, 2(1): 16-23. doi: 10.1007/s12548-009-0003-2
[27]	Bertram S, Moriggl A, Rudisch A, et al. Structural characteristics of bilateral temporomandibular joint disc displacement without reduction and osteoarthrosis are important determinants of horizontal mandibular and vertical ramus deficiency: A magnetic resonance imaging study[J]. J Oral Maxillofac Surg, 2011, 69(7): 1898-1904. doi: 10.1016/j.joms.2010.12.026
[28]	Hsieh YJ, Darvann TA, Hermann NV, et al. Three-dimensional assessment of facial morphology in children and adolescents with juvenile idiopathic arthritis and moderate to severe TMJ involvement using 3D surface scans[J]. Clin Oral Investig, 2020, 24(2): 799-807. doi: 10.1007/s00784-019-02962-5
[29]	Lin M, Xu YF, Wu H, et al. Comparative cone-beam computed tomography evaluation of temporomandibular joint position and morphology in female patients with skeletal Class Ⅱ malocclusion[J]. J Int Med Res, 2020, 48(2): 300060519892388. doi: 10.1177/0300060519892388
[30]	Noh KJ, Baik HS, Han SS, et al. Differences in mandibular condyle and glenoid Fossa morphology in relation to vertical and sagittal skeletal patterns: A cone-beam computed tomography study[J]. Korean J Orthod, 2021, 51(2): 126-134. doi: 10.4041/kjod.2021.51.2.126 pmid: 33678628
[31]	Ma HD, Teng HD, Li AN, et al. The pressure in the temporomandibular joint in the patients with maxillofacial deformities[J]. J Stomatol Oral Maxillofac Surg, 2023, 124(1S): 101285.
[32]	Wang J, Dong X, Lei J, et al. β-catenin orchestrates Gli1⁺ cell fate in condylar development and TMJOA[J]. J Dent Res, 2024, 103(12): 1291-1301. doi: 10.1177/00220345241274354
[33]	Li W, Wu N, Wang JM, et al. Role of HIF-2α/NF-κB pathway in mechanical stress-induced temporomandibular joint osteoarthritis[J]. Oral Dis, 2022, 28(8): 2239-2247. doi: 10.1111/odi.v28.8
[34]	Arieta-Miranda JM, Silva-Valencia M, Flores-Mir C, et al. Spatial analysis of condyle position according to sagittal skeletal relationship, assessed by cone beam computed tomography[J]. Prog Orthod, 2013, 14: 36. doi: 10.1186/2196-1042-14-36 pmid: 24325842
[35]	Park IY, Kim JH, Park YH. Three-dimensional cone-beam computed tomography based comparison of condylar position and morphology according to the vertical skeletal pattern[J]. Korean J Orthod, 2015, 45(2): 66-73. doi: 10.4041/kjod.2015.45.2.66
[36]	Saccomanno S, Deli R, DI Cintio G, et al. Retrospective epidemiological study of mandibular rotational types in patients with orthodontical malocclusion[J]. Acta Otorhinolaryngol Ital, 2018, 38(2): 160-165. doi: 10.14639/0392-100X-1682 pmid: 29967561
[37]	Jung WS, Kim H, Jeon DM, et al. Magnetic resonance imaging-verified temporomandibular joint disk displacement in relation to sagittal and vertical jaw deformities[J]. Int J Oral Maxillofac Surg, 2013, 42(9): 1108-1115. doi: 10.1016/j.ijom.2013.03.012

	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

Correlation between the changes of articular disc and mandibular morphology in adult women with temporomandibular disorders symptoms

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 8

References 37

Related Articles 15

Recommended Articles

Metrics

Comments

关节盘	总数	位置			形态
关节盘	总数	正常	DDwR	DDwoR	基本正常	异常
右侧R	223	84	48	91	120	103
左侧L	223	69	77	77	125	98

[1]	XUE Qing, SI Jiarui, SUN Yanyu, WANG Hao, CHENG Qiaoyu, XIONG Xin. Analysis of differences in oral behaviors among 212 patients with acute and chronic pain associated with temporomandib-ular disorders [J]. Stomatology, 2025, 45(9): 681-686.
[2]	WANG Jing, ZHANG Linkun, ZHANG Chunxiang, LIN Chen, JIN Jing, WANG Tianqi, LIU Dongqiao. The difference of condyle position in patients with temporomandibular disorders [J]. Stomatology, 2025, 45(6): 424-429.
[3]	LIU Fei, ZHANG Jiulou, JIN Ruofan, ZHANG Nan, ZHOU Weina. The automatic segmentation of the temporomandibular joint based on MRI using deep learning method [J]. Stomatology, 2025, 45(6): 445-452.
[4]	XUE Mingfei, SHU Wei, ZHANG Jiajia, HU Jiayi. Analysis of therapeutic effect of ultrasound combined with external application of Chinese medicine in the treatment of temporomandibular disorders [J]. Stomatology, 2025, 45(11): 854-857.
[5]	WANG Yang, TU Meijie, DENG Shuli. Current applications and future prospects of magnetic resonance imaging in oral medicine [J]. Stomatology, 2025, 45(11): 869-875.
[6]	WANG Pengcheng, CHEN Chunhui, TONG Xi, FU Xinhai. Effects of extracorporeal shock wave assisted drug therapy on patients with temporomandibular joint disorder [J]. Stomatology, 2024, 44(11): 856-859.
[7]	WEI Lili, LI Bo, CHENG Yong. Advances in the clinical application of MRI in temporomandibular joint disorders [J]. Stomatology, 2024, 44(1): 11-15.
[8]	ZHAO Ning, FANG Bing. Research progress of orthodontics and temporomandibular disorders [J]. Stomatology, 2024, 44(1): 20-23.
[9]	ZHU Jinyi, GONG Yanji, ZHENG Fangjie, YU Shibin, YIN Deqiang, LIU Yang. Reevaluation of the association between the malocclusion and temporomandibular disorders [J]. Stomatology, 2024, 44(1): 24-30.
[10]	FU Kaiyuan, LEI Jie. Update of the classification, diagnosis and management of temporomandibular disorders [J]. Stomatology, 2024, 44(1): 6-10.
[11]	XU Wenxin,MA Yufeng. Questionnaire survey and risk factor analysis of temporomandibular joint disorders among vocal students [J]. Stomatology, 2023, 43(4): 343-346.
[12]	ZHOU Zhijie, HONG Yueyang, XU Yan. Three dimensional analysis of localized dentition and mandibular morphology in patients with mesio-impacted mandibular second molars [J]. Stomatology, 2023, 43(11): 1008-1013.
[13]	QIAN Min, WU Mengjie. Review of MRI-based three-dimensional model reconstruction of temporomandibular joint [J]. Stomatology, 2023, 43(10): 930-934.
[14]	ZHAO Mingcan, WANG Xiuli, HAO Xinqing, LI Xiaobing, QI Huichuan, HUANG Yang. A new method for distal movement of unilateral mandibular first permanent molar and evaluation of its clinical efficacy [J]. Stomatology, 2022, 42(8): 707-712.
[15]	Min ZHU. Progress of research on temporomandibular joint changes after orthopedic treatment on skeletal Class Ⅱ malocclusion in adolescents [J]. , 2021, 41(11): 1047-1051.