Gupta Deepak, Rashmi N C, Sheikh Soheyl, Pallagatti Shambulingappa, Goyal Gaurav, Singh Ravinder, Parnami Priyanka, Singh Gundeep
Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India,
Oral Maxillofac Surg. 2014 Dec;18(4):453-7. doi: 10.1007/s10006-013-0438-x. Epub 2013 Dec 7.
Although the incidence of zygomatic air cell defects (ZACDs) is significantly low in general population, still they pose as a risk factor during surgical procedures like eminectomies and eminoplasties because there is a risk of spread of infection intracranially. Furthermore, such procedures are more common in TMD patients. With this fact in mind, this study was designed to find out the prevalence, radiographic appearance, and characteristics of zygomatic air cell defects in diagnosed symptomatic temporomandibular joint disorder patients.
The study comprised of evaluation of panoramic radiographs of 70 temporomandibular joint disorder (TMD) patients in the age range of 18-30 years selected on the basis of Research Diagnostic Criteria (RDC/TMD). The radiographs were evaluated regarding the presence, variations, and characteristics of ZACDs. Groups were compared by χ (2) analysis.
ZACDs were identified in 21 TMD subjects out of 70, giving an overall prevalence of 30 %. Out of 21 ZACDs, nine were in males (42.8 %) and 12 were in females (52.38 %). ZACDs were unilateral in ten TMD patients (47.61 %) and were bilateral in 11 patients (52.38 %).
It can be concluded that the number of ZACDs is surprisingly more in diagnosed TMD patients. This strengthens the need for thorough preoperative imaging evaluation of ZACDs in such patients. Further longitudinal studies are required to find out the long-term effect of ZACDs on symptomatic as well as non-symptomatic TMD subjects. This may prove helpful to appreciate that whether ZACDs have any role in the development TMDs and vice versa. As with many TMD studies, caution should be exercised in interpreting these results until further studies have been carried out on this topic. Ideally, some prospective randomised evaluations with "hard" evidence of the diagnosis with MRI support.
尽管颧骨气房缺损(ZACD)在普通人群中的发生率显著较低,但在诸如乳突切除术和乳突成形术等外科手术过程中,它们仍构成风险因素,因为存在颅内感染扩散的风险。此外,此类手术在颞下颌关节紊乱症(TMD)患者中更为常见。鉴于这一事实,本研究旨在找出已确诊的有症状颞下颌关节紊乱症患者中颧骨气房缺损的患病率、影像学表现及特征。
本研究包括对70例年龄在18至30岁之间、根据研究诊断标准(RDC/TMD)选取的颞下颌关节紊乱症(TMD)患者的全景X线片进行评估。对X线片评估颧骨气房缺损的存在情况、变异及特征。通过χ²分析对各组进行比较。
在70例TMD受试者中,21例发现有颧骨气房缺损,总体患病率为30%。在21例颧骨气房缺损中,9例为男性(42.8%),12例为女性(52.38%)。10例TMD患者的颧骨气房缺损为单侧(47.61%),11例为双侧(52.38%)。
可以得出结论,在已确诊的TMD患者中,颧骨气房缺损的数量惊人地多。这强化了对此类患者进行全面术前颧骨气房缺损影像学评估的必要性。需要进一步的纵向研究来找出颧骨气房缺损对有症状及无症状TMD受试者的长期影响。这可能有助于了解颧骨气房缺损在颞下颌关节紊乱症的发生发展中是否起作用,反之亦然。与许多TMD研究一样,在对该主题进行进一步研究之前,解读这些结果时应谨慎。理想情况下,应进行一些有“确凿”诊断证据支持的前瞻性随机评估,并结合MRI检查。