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使用头影测量分析评估有症状患者颞下颌关节盘移位及其进展对牙颌面形态的影响。

Evaluation of the effects of temporomandibular joint disk displacement and its progression on dentocraniofacial morphology in symptomatic patients using lateral cephalometric analysis.

作者信息

Sakar Olcay, Calisir Funda, Oztas Evren, Marsan Gülnaz

机构信息

Department of Prosthodontics, Faculty of Dentistry of Istanbul University, Istanbul, Turkey.

出版信息

Cranio. 2011 Jul;29(3):211-8. doi: 10.1179/crn.2011.030.

Abstract

The aim of this study was to evaluate the effects of disk displacement (DD) and its progression on dentocraniofacial morphology in symptomatic patients and compare the results with asymptomatic volunteers. Skeletal and dental Class I female patients with DD, diagnosed using magnetic resonance imaging (MRI) and lateral cephalometric analysis were included in the study. Subjects were grouped as follows: control group with bilateral normal disk position (group 1, n=12), unilateral DD with reduction (group 2, n=16), bilateral DD with reduction (group 3, n=26), unilateral DD without reduction (group 4, n=12), and bilateral DD without reduction (group 5, n=8). Thirty-two (32) cephalometric variables were measured, and statistically significant differences were found in 11. Dental and soft tissue measurements did not reveal any differences, but variables related to the mandible showed statistically significant differences. Progression of DD was associated with an increase in all angular measurements related to vertical skeletal relationships and articular angle and a decrease in the ratio of posterior face height to anterior face height indicating clockwise rotation of the mandible. Similarly, the height of ramus was decreased with the progression of DD. The results of this study demonstrated that the presence of DD in skeletal Class I female patients effects facial morphology, and its progression makes the differences more significant and remarkable. These results emphasize the importance of early diagnosis and treatment in the management of DD.

摘要

本研究的目的是评估有症状患者中盘移位(DD)及其进展对牙颌面形态的影响,并将结果与无症状志愿者进行比较。研究纳入了通过磁共振成像(MRI)和头颅侧位片分析诊断为DD的骨骼和牙齿I类女性患者。受试者分组如下:双侧盘位置正常的对照组(第1组,n = 12)、单侧可复性DD组(第2组,n = 16)、双侧可复性DD组(第3组,n = 26)、单侧不可复性DD组(第4组,n = 12)和双侧不可复性DD组(第5组,n = 8)。测量了32个头颅侧位片变量,其中11个存在统计学显著差异。牙齿和软组织测量未发现任何差异,但与下颌骨相关的变量显示出统计学显著差异。DD的进展与所有与垂直骨骼关系和关节角相关的角度测量值增加以及后脸高与前脸高之比降低有关,这表明下颌骨顺时针旋转。同样,随着DD的进展,下颌升支高度降低。本研究结果表明,骨骼I类女性患者中DD的存在会影响面部形态,其进展会使差异更加显著。这些结果强调了DD管理中早期诊断和治疗的重要性。

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