Wang Zhi-hui, Jiang Lan, Zhao Yan-ping, Ma Xu-chen
Center for Temporomandibular Disorders and Orofacial Pain, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2013 Apr 18;45(2):280-5.
To investigate the occurrence and radiographic signs of osteoarthrosis of the temporomandibular joints (TMJOA) with cone beam computed tomography (CBCT) in adolescents.
Individuals with temporomandibular disorders (aged 10-19 years) in the patients group (n=386) and pre-orthodontic patients with malocclusion (aged 10-19 years) in the control group (n=339) were included in the present study. All the patients in both groups had been examined by CBCT. The abnormalities of the condyle were evaluated. The results of radiological findings were compared between the patients group and the controls by using chi-square tests. Inter- and intra-examiner agreements were assessed using Cohen's Kappa coefficient and all statistical analysis was performed using SPSS 13.0.
157 patients in the patients group and 41 subjects in the control group had radiographic signs of TMJOA. The occurrence of OA was significantly higher in the patients group (40.7%, 157/386) than in the controls (12.1%, 41/339), the difference was statistically significant (P<0.05). The occurrence of TMJOA was significantly higher in females (44.6%, 123/276) than in males (30.9%, 34/110) in the patients group (P<0.05) but showed no significant difference in the controls (females: 13.7%, 32/234, and male: 8.6%, 9/105, P>0.05). In addition, the patients group showed significantly higher occurrence of ill-defined cortical bone (31.7%, 65/205) small bony defect and extensive erosion (25.4%, 52/205) than the controls (1.7%, 1/58 and 5.2%, 3/58, respectively, P<0.05), while the subjects in the control group had significantly higher occurrence of flattening and shortening of the condyle (39.7%, 23/58) and sclerosis (39.7%, 23/58) than patients with temporomandibular disorders (6.3%,13/205 and 14.6%, 30/205, respectively, P<0.05).
TMJOA is not uncommon in adolescent patients with TMD and with malocclusion. Patients in the two study groups had different radiographic signs of OA. The patients with temporomandibular disorders often demonstrate erosive changes, while the pre-orthodontic patients with malocclusion often demonstrate relatively stable radiographic signs.
采用锥形束计算机断层扫描（CBCT）研究青少年颞下颌关节骨关节炎（TMJOA）的发生情况及影像学特征。
患者组纳入386例患有颞下颌关节紊乱病的个体（年龄10 - 19岁），对照组纳入339例错牙合畸形的正畸治疗前患者（年龄10 - 19岁）。两组所有患者均接受CBCT检查。评估髁突的异常情况。采用卡方检验比较患者组和对照组的影像学检查结果。使用Cohen's Kappa系数评估检查者间和检查者内的一致性，所有统计分析均使用SPSS 13.0软件进行。
患者组有157例患者、对照组有41例受试者有TMJOA的影像学特征。患者组骨关节炎的发生率（40.7%，157/386）显著高于对照组（12.1%，41/339），差异有统计学意义（P<0.05）。患者组中女性TMJOA的发生率（44.6%，123/276）显著高于男性（30.9%，34/110）（P<0.05），但对照组中无显著差异（女性：13.7%，32/234；男性：8.6%，9/105，P>0.05）。此外，患者组中皮质骨边界不清（31.7%，65/205）、小骨缺损和广泛侵蚀（25.4%，52/205）的发生率显著高于对照组（分别为1.7%，1/58和5.2%，3/58，P<0.05），而对照组受试者髁突扁平缩短（39.7%，23/58）和硬化（39.7%，23/58）的发生率显著高于颞下颌关节紊乱病患者（分别为6.3%，13/205和14.6%，30/205，P<0.05）。
TMJOA在患有颞下颌关节紊乱病和错牙合畸形的青少年患者中并不少见。两个研究组患者的OA影像学特征不同。颞下颌关节紊乱病患者常表现为侵蚀性改变，而错牙合畸形的正畸治疗前患者常表现为相对稳定的影像学特征。
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