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骨性III类错颌儿童上颌前牵引后颞下颌关节的三维变化

Three-dimensional changes in the temporomandibular joint after maxillary protraction in children with skeletal Class III malocclusion.

作者信息

Lee Hyunju, Son Woo-Sung, Kwak Chun, Kang Eun-Hee, Kim Seong-Sik, Park Soo-Byung, Kim Yong-Il

机构信息

Department of Orthodontics, School of Dentistry, Pusan National University.

出版信息

J Oral Sci. 2016;58(4):501-508. doi: 10.2334/josnusd.16-0251.

Abstract

We evaluated 3-dimensional changes in the temporomandibular joints of children with skeletal Class III malocclusion and maxillary deficiency after facemask therapy for maxillary protraction. Eighteen children with anterior crossbite and a Class III molar relationship underwent facemask therapy for maxillary protraction, after which they exhibited positive overjet and a Class II molar relationship. Three-dimensional cone-beam computed tomography images of the patients were obtained before (T1) and after (T2) facemask protraction, and the 3-dimensional coordinates of the anatomical landmarks in T1 and T2 images were compared. After facemask therapy, the mandibular condyles of the patients were displaced outside, upward, and backward. Additionally, the anterior and posterior walls of the glenoid fossa had negative values for anteroposterior change. Three-dimensional analysis of the temporomandibular joint showed that facemask therapy resulted in bone apposition (to the anterior wall) and bone resorption (of the posterior wall) in the glenoid fossa. This bone remodeling resulted in upward and backward displacement of the condyle.(J Oral Sci 58, 501-508, 2016).

摘要

我们评估了面罩治疗上颌前牵引后,骨骼Ⅲ类错牙合伴上颌骨发育不足儿童颞下颌关节的三维变化。18名前牙反牙合且磨牙为Ⅲ类关系的儿童接受了面罩上颌前牵引治疗,治疗后他们表现出正覆盖和Ⅱ类磨牙关系。在面罩牵引前(T1)和牵引后(T2)获取患者的三维锥形束计算机断层扫描图像,并比较T1和T2图像中解剖标志点的三维坐标。面罩治疗后,患者的下颌髁突向外、向上和向后移位。此外,关节窝的前壁和后壁前后向变化值为负。颞下颌关节的三维分析表明,面罩治疗导致关节窝骨增生(在前壁)和骨吸收(在 后壁)。这种骨重塑导致髁突向上和向后移位。(《口腔科学杂志》58, 501 - 508, 2016)

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