Kommers Sofie, Moghimi Meshkan, van de Ven Lisanne, Forouzanfar Tymour
Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA) P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA) P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
Br J Oral Maxillofac Surg. 2014 Jul;52(6):491-5. doi: 10.1016/j.bjoms.2014.04.008. Epub 2014 May 27.
Several studies have published measurements of the height of the ramus on orthopantomographic (OPT) images of patients with unilateral fractures of the mandibular condyle as a possible quantitative measure for making decisions about treatment. However, we know of no studies that have described the accuracy and validity of such measurements. The aim of the present study was to assess the shortening of the ramus in patients with such fractures, and compare them with differences found in a control group. Seventy-four patients and 74 controls were studied. The height of the ramus on the fractured was less than that on the uninjured side, although this was not statistically significant (p=0.25). In the control group, 50 subjects (68%) had a difference in the ramal height of more than 2mm. Of 74 patients, 25 (34%) had a shorter, uninjured ramus on the opposite side. A Bland and Altman scatterplot showed 23 outliers (31%) among the patients, which exceeded the mean (SD 1.96) of the control group. The interobserver and intraobserver reliability both showed excellent agreement for all measurements made. Shortening of the ramus can be measured on OPT images. However, in a control group there was a large mean difference in height. Among the patients, 25/74 (34%) also had an uninjured ramus on the opposite side that was shorter than that on the fractured side. Measurement of the difference in height on an OPT image cannot be relied on as an absolute indication for intervention.
多项研究已发表了关于下颌骨髁突单侧骨折患者的口腔全景断层（OPT）图像上升支高度的测量结果，作为制定治疗决策的一种可能的定量指标。然而，我们尚未发现有研究描述此类测量的准确性和有效性。本研究的目的是评估此类骨折患者升支的缩短情况，并将其与对照组中发现的差异进行比较。对74例患者和74名对照者进行了研究。骨折侧升支的高度低于未受伤侧，尽管这在统计学上无显著差异（p = 0.25）。在对照组中，50名受试者（68%）的升支高度差异超过2mm。在74例患者中，25例（34%）对侧未受伤的升支较短。Bland和Altman散点图显示患者中有23个异常值（31%），超过了对照组的均值（标准差1.96）。观察者间和观察者内的可靠性在所有测量中均显示出极佳的一致性。升支的缩短可以在OPT图像上测量。然而，对照组中高度的平均差异较大。在患者中，25/74（34%）对侧未受伤的升支也比骨折侧的短。不能将OPT图像上高度差异的测量结果作为干预的绝对指征。
