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下颌矢状劈开截骨术治疗下颌骨前突前后颞下颌关节的形态学变化

Morphological changes in the temporomandibular joint before and after sagittal splitting ramus osteotomy of the mandible for skeletal mandibular protrusion.

作者信息

Enami Koji, Yamada Kazuhiro, Kageyama Toru, Taguchi Akira

机构信息

Baycity Dental Clinic.

出版信息

Cranio. 2013 Apr;31(2):123-32. doi: 10.1179/crn.2013.020.

Abstract

Changes of temporomandibular joint (TMJ) morphology were analyzed in 21 patients with mandibular protrusion corrected using bilateral sagittal split ramus osteotomy (SSRO) and mini-plate fixation with TMJ cephalometric laminographs. The condylar pass angle, eminence to the FH plane angle, and total height of fossa and lower height of fossa in both left and right sides, significantly decreased after surgery. The width of the condyle, in both left and right sides, significantly increased after treatment. However, in the joint spaces, there were no significant differences before and after treatment. The amount of change in the eminence to the FH plane angle, total height of fossa and lower height of fossa, before and after surgery, showed significant positive correlations with that of SNB, before and after surgery. These results suggest that adaptive bone remodeling of the TMJ might occur due to the correction of occlusion and craniofacial morphology by SSRO in patients with mandibular protrusion.

摘要

使用双侧矢状劈开下颌支截骨术(SSRO)和微型钢板固定,并通过颞下颌关节(TMJ)头颅测量分层X线片,对21例接受下颌前突矫正的患者的TMJ形态变化进行了分析。术后双侧髁突通过角、关节结节与FH平面夹角以及关节窝总高度和关节窝下高度均显著降低。治疗后双侧髁突宽度显著增加。然而,关节间隙在治疗前后无显著差异。术前术后关节结节与FH平面夹角、关节窝总高度和关节窝下高度的变化量与术前术后SNB的变化量呈显著正相关。这些结果表明,在下颌前突患者中,SSRO对咬合和颅面形态的矫正可能导致TMJ的适应性骨重塑。

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