Cevidanes Lucia H, Walker David G, Styner Martin, Lim Pei Feng
Craniofac Growth Ser. 2009 Mar;46:147-157.
The objective of this study is to determine the nature of the difference between condyle morphology of osteoarthritic temporomandibular joint (TMJ) and non-osteoarthritic TMJ, using 3D surface models constructed from cone-beam CT (CBCT) images. Three-dimensional Shape Correspondence was used to localize and quantify condylar morphological differences of 20 patients with RDC/TMD group III (arthralgia, arthritis, arthrosis) compared to 40 asymptomatic subjects. Three-dimensional models of right and left condyles for each subject were constructed from CBCT images and shape analysis performed using the publicly available SPHARM-PDM software. The right and left condyles were normalized using rigid Procrustes alignment to an overall mean condylar surface per group. The mean differences between groups were compared using the Hotelling T2 analysis with permutation-test derived p-values, corrected for False Discovery Rate. The differences between the group mean surfaces were visualized with color-coded magnitude and difference vectors. The condylar morphology of the TMD group was statistically significantly different from the asymptomatic group (p = 0.05, average surface distance differences of 1.9 mm for the right condyles and 2.3 mm for the left condyles). The average condylar morphology in the TMD patients showed resorption of the anterior surface of the lateral pole and flattening of the articular surface compared to the mean morphology in asymptomatic subjects. The condylar morphology and condylar dimensions of the TMD patients were different, on average, from those of the asymptomatic subjects. The preliminary findings in this cross-sectional study will lead to future investigations to elucidate osteoarthritic changes in TMD and their role in the pathophysiology of TMD. Supported by NIDCR DE017727.
本研究的目的是利用锥形束CT(CBCT)图像构建的三维表面模型,确定骨关节炎性颞下颌关节(TMJ)与非骨关节炎性TMJ髁突形态之间差异的性质。使用三维形状对应法对20例RDC/TMD III组(关节痛、关节炎、关节病)患者与40例无症状受试者的髁突形态差异进行定位和量化。从CBCT图像构建每个受试者左右髁突的三维模型,并使用公开可用的SPHARM-PDM软件进行形状分析。使用刚性普氏对齐将左右髁突归一化为每组的总体平均髁突表面。使用Hotelling T2分析和置换检验得出的p值比较组间平均差异,并针对错误发现率进行校正。用颜色编码的幅度和差异向量可视化组平均表面之间的差异。TMD组的髁突形态与无症状组在统计学上有显著差异(p = 0.05,右侧髁突平均表面距离差异为1.9 mm,左侧髁突为2.3 mm)。与无症状受试者的平均形态相比,TMD患者的平均髁突形态显示外侧极前表面吸收和关节表面变平。TMD患者的髁突形态和髁突尺寸平均与无症状受试者不同。这项横断面研究的初步结果将促使未来开展研究,以阐明TMD中的骨关节炎变化及其在TMD病理生理学中的作用。由美国国立牙科和颅面研究所DE017727资助。