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颞下颌关节不可复性盘移位时髁突高度的降低是否比可复性盘移位时更多?一项磁共振成像回顾性研究。

Does condylar height decrease more in temporomandibular joint nonreducing disc displacement than reducing disc displacement?: A magnetic resonance imaging retrospective study.

作者信息

Hu Ying-Kai, Yang Chi, Cai Xie-Yi, Xie Qian-Yang

机构信息

Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China.

出版信息

Medicine (Baltimore). 2016 Aug;95(35):e4715. doi: 10.1097/MD.0000000000004715.

Abstract

The aim of the study was to compare condylar height changes of anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDwoR) in temporomandibular joint (TMJ) quantitatively, to get a better understanding of the changes in condylar height of patients with anterior disc displacement who had received no treatment, and to provide useful information for treatment protocol. This longitudinal retrospective study enrolled 206 joints in 156 patients, which were divided into ADDWR group and ADDwoR group based on magnetic resonance imaging examination. The joints were assessed quantitatively for condylar height at initial and follow-up visits. Also, both groups were further divided into 3 subgroups according to age: <15 years group, 15 to 21 years group, and 22 to 35 years group. Paired t test and independent t test were used to assess intra- and intergroup differences. The average age of the ADDwR group was 19.65 years with a mean of 9.47 months' follow-up. The follow-up interval of the patients with ADDwoR was 7.96 months, with a mean age of 18.51 years. Condylar height in ADDwoR tended to decrease more than those in ADDwR, especially during the pubertal growth spurt and with the presence of osteoarthrosis, meaning ADDwoR could cause a severe disturbance in mandibular development. Thus, an early disc repositioning was suggested to avoid decrease in condylar height.

摘要

本研究的目的是定量比较颞下颌关节(TMJ)中可复性盘前移位(ADDwR)和不可复性盘前移位(ADDwoR)患者髁突高度的变化,以更好地了解未经治疗的盘前移位患者髁突高度的变化,并为治疗方案提供有用信息。这项纵向回顾性研究纳入了156例患者的206个关节,根据磁共振成像检查将其分为ADDWR组和ADDwoR组。在初次就诊和随访时对关节的髁突高度进行定量评估。此外,两组均根据年龄进一步分为3个亚组:<15岁组、15至21岁组和22至35岁组。采用配对t检验和独立t检验评估组内和组间差异。ADDwR组的平均年龄为19.65岁,平均随访9.47个月。ADDwoR患者的随访间隔为7.96个月,平均年龄为18.51岁。ADDwoR患者的髁突高度比ADDwR患者下降得更多,尤其是在青春期生长突增期间以及存在骨关节炎的情况下,这意味着ADDwoR可能会严重干扰下颌骨发育。因此,建议早期进行盘复位以避免髁突高度降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fce/5008593/5bec09ec30a7/medi-95-e4715-g001.jpg

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