Chang Ah Ryum, Han Jeong Joon, Kim Dae-Seung, Yi Won-Jin, Hwang Soon Jung
Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Republic of Korea.
Interdisciplinary Program in Radiation, Applied Life Science Major, College of Medicine, BK21, and Dental Research Institute, Seoul National University, Republic of Korea.
J Craniomaxillofac Surg. 2015 Apr;43(3):342-8. doi: 10.1016/j.jcms.2014.12.015. Epub 2015 Jan 7.
Functional overloading can lead to disc displacement in the temporomandibular joint (TMJ), and a high incidence of disc displacement has been reported in patients with facial asymmetry. The aim of this study was to assess the dynamic condylar movement in patients (n = 26) with facial asymmetry using a simulation system with 3-dimensional computed tomographic images and tracking camera system.
The intra-articular distance (IAD) between the condyle and glenoid fossa was recorded during TMJ movement as a parameter for functional overloading and compared between Group I with severe asymmetry and Group II with mild asymmetry.
The average IAD was shorter in Group I than Group II, especially at the lowest point (P < 0.05). The ratio of IAD narrowing in Group I was significantly larger than in Group II (P < 0.05). The mean IAD were slightly smaller on the deviated side (3.41 mm) than on the nondeviated side (3.55 mm) in Group I, even though there was no statistical significance. The maximum displacement in Group I was longer than in Group II and had no significant difference between deviated side and nondeviated side.
We suggested that the reduced IAD resulting from TMJ overloading can lead to internal derangement in severe facial asymmetry.
功能过载可导致颞下颌关节(TMJ)盘移位,面部不对称患者的盘移位发生率较高。本研究的目的是使用三维计算机断层扫描图像模拟系统和跟踪摄像系统,评估面部不对称患者(n = 26)的髁突动态运动。
在颞下颌关节运动过程中记录髁突与关节窝之间的关节内距离(IAD),作为功能过载的参数,并在严重不对称的I组和轻度不对称的II组之间进行比较。
I组的平均IAD比II组短,尤其是在最低点(P < 0.05)。I组IAD变窄的比例明显大于II组(P < 0.05)。I组中,偏斜侧的平均IAD(3.41 mm)略小于非偏斜侧(3.55 mm),尽管无统计学意义。I组的最大位移比II组长,且偏斜侧与非偏斜侧之间无显著差异。
我们认为,颞下颌关节过载导致的IAD减小可导致严重面部不对称中的关节内紊乱。