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[在使用Herbst矫治器进行两阶段治疗期间颞下颌关节骨结构的锥形束计算机断层扫描分析]

[Cone beam computed tomography analysis of the bony structure of the temporomandibular joint during two phase treatment with Herbst appliance].

作者信息

Weiwei Chen, Ting Sang, Zhen Huang, Jun Wu

机构信息

Dept. of Stomatology, Traditional Chinese Medicine and Western Medicine Combination Hospital of Nanchang City, Nanchang 330006, China.

Dept. of Orthodontics, The Affiliated Stomatological Hospital of Nanchang University, Nanchang 330006, China.

出版信息

Hua Xi Kou Qiang Yi Xue Za Zhi. 2016 Oct 1;34(5):498-501. doi: 10.7518/hxkq.2016.05.013.

DOI:10.7518/hxkq.2016.05.013
PMID:28326709
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7030136/
Abstract

OBJECTIVE

This study assessed the effects of two-phase treatment with Herbst appliance on the bony structure of the temporomandibular joint via cone beam computed tomography (CBCT) analysis.

METHODS

This study selected 15 patients exhibiting early permanent dentition and classⅡmalocclusion combined with mandibular retrusion treated by a two phase treatment (Herbst and fixed appliance). The CBCT scans of the patients were obtained at the following stages: 2 weeks before Herbst treatment (T1), at the start of treatment when the Herbst appliance was set in place (T2), immediately after removal of the Herbst appliance (T3), and immediately after removal of the edgewise appliance (T4). Three-dimensional reconstruction and related measurements were performed using InvivoDental software, and the acquired data were statistically analyzed.

RESULTS

  1. CBCT showed a crescent-shaped hyperplasia at the posterior-superior border of the condyles that the outer edge was highly dense and the inner region was lowly dense in T3 in 14 patients (28 condyles). 2) In T3-T2 and T4-T1, the diameters of the anteroposterior condyles increased by 0.62 and 0.66 mm, respectively (P<0.01), and the condylar head height correspondingly increased by 0.54 and 0.53 mm (P<0.01).

CONCLUSIONS: Condylar growth remodeling occurs during Herbst treatment.
.

摘要

目的

本研究通过锥形束计算机断层扫描（CBCT）分析评估Herbst矫治器两期治疗对颞下颌关节骨结构的影响。

方法

本研究选取15例恒牙早期且安氏Ⅱ类错合伴下颌后缩的患者，采用两期治疗（Herbst矫治器和固定矫治器）。在以下阶段获取患者的CBCT扫描图像：Herbst治疗前2周（T1）、Herbst矫治器就位开始治疗时（T2）、Herbst矫治器拆除后即刻（T3）、方丝弓矫治器拆除后即刻（T4）。使用InvivoDental软件进行三维重建和相关测量，并对获取的数据进行统计学分析。

结果

1）CBCT显示，14例患者（28个髁突）在T3时髁突后上缘出现新月形增生，外缘高密度，内部区域低密度。2）在T3 - T2和T4 - T1阶段，髁突前后径分别增加0.62和0.66 mm（P<0.01），髁突头部高度相应增加0.54和0.53 mm（P<0.01）。

结论

Herbst治疗期间髁突发生生长改建。

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引用本文的文献

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Effectiveness of comprehensive fixed appliance treatment used with the Forsus Fatigue Resistant Device in Class II patients.应用 Forsus 疲劳阻力矫治器的综合性固定矫正治疗对安氏Ⅱ类患者的疗效。
Angle Orthod. 2011 Jul;81(4):678-83. doi: 10.2319/102710-629.1. Epub 2011 Feb 7.
2
Changes in temporomandibular joint disc position and form following Herbst and fixed orthodontic treatment.赫伯氏矫治器及固定正畸治疗后面下颌关节盘位置和形态的改变。
Angle Orthod. 2010 Sep;80(5):843-52. doi: 10.2319/093009-545.1.
3
The effect of mandibular protrusive (activator) appliances on articular eminence morphology.
Angle Orthod. 2003 Dec;73(6):647-53. doi: 10.1043/0003-3219(2003)073<0647:TEOMPA>2.0.CO;2.
4
Amount and direction of temporomandibular joint growth changes in Herbst treatment: a cephalometric long-term investigation.Herbst矫治器治疗中颞下颌关节生长变化的量与方向：一项头影测量长期研究
Angle Orthod. 2003 Oct;73(5):493-501. doi: 10.1043/0003-3219(2003)073<0493:AADOTJ>2.0.CO;2.
5
VEGF and bone formation in the glenoid fossa during forward mandibular positioning.
Am J Orthod Dentofacial Orthop. 2002 Aug;122(2):202-9. doi: 10.1067/mod.2002.125991.
6
Effective condylar growth and chin position changes in activator treatment: a cephalometric roentgenographic study.功能性矫治器治疗中髁突有效生长及颏部位置变化：一项头影测量X线影像学研究
Angle Orthod. 2001 Feb;71(1):4-11. doi: 10.1043/0003-3219(2001)071<0004:ECGACP>2.0.CO;2.
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Does bite-jumping damage the TMJ? A prospective longitudinal clinical and MRI study of Herbst patients.咬合跳跃会损伤颞下颌关节吗？一项针对Herbst矫治器患者的前瞻性纵向临床及磁共振成像研究。
Angle Orthod. 2000 Jun;70(3):183-99. doi: 10.1043/0003-3219(2000)070<0183:DBJDTT>2.0.CO;2.
8
Temporomandibular joint remodeling in adolescents and young adults during Herbst treatment: A prospective longitudinal magnetic resonance imaging and cephalometric radiographic investigation.青少年和年轻成人在Herbst矫治器治疗期间颞下颌关节重塑：一项前瞻性纵向磁共振成像和头影测量X线摄影研究。
Am J Orthod Dentofacial Orthop. 1999 Jun;115(6):607-18. doi: 10.1016/s0889-5406(99)70285-4.
9
Temporomandibular joint growth adaptation in Herbst treatment: a prospective magnetic resonance imaging and cephalometric roentgenographic study.Herbst矫治器治疗中颞下颌关节的生长适应性：一项前瞻性磁共振成像和头影测量X线摄影研究
Eur J Orthod. 1998 Aug;20(4):375-88. doi: 10.1093/ejo/20.4.375.
10
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Eur J Orthod. 1997 Dec;19(6):657-68. doi: 10.1093/ejo/19.6.657.