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颞下颌关节紊乱病中的实时三维颌骨跟踪

Real-time three-dimensional jaw tracking in temporomandibular disorders.

作者信息

da Cunha D V, Degan V V, Vedovello Filho M, Bellomo D P, Silva M R, Furtado D A, Andrade A O, Milagre S T, Pereira A A

机构信息

Laboratory of Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlândia, Uberlândia, Brazil.

Department of Orthodontics, Faculty of Dentistry, Hermínio Ometto University, Araras, Brazil.

出版信息

J Oral Rehabil. 2017 Aug;44(8):580-588. doi: 10.1111/joor.12521. Epub 2017 Jun 10.

Abstract

When a dysfunction occurs in any component of the stomatognathic system, temporomandibular disorders (TMD) may originate. The aim of this study was to compare the deviations, displacement and the execution speed of mandibular movements among asymptomatic participants and those with TMD. Convenience sampling was used; forty participants diagnosed by clinical evaluation following the Research Diagnostic Criteria for Temporomandibular Disorders were divided into three groups: arthropathy (GART, 10 participants, 40% men), myopathy (GMYO, 10 participants, 30% men), and the control group (CG, 20 asymptomatic participants, 25% men). Participants were asked to perform the movements of free maximal mouth opening and closing, right and left lateral excursions, and protrusion with sliding teeth contacts. The mandibular trajectory was recorded using opto-electronic devices tracking reflective markers placed in front of the 'soft tissue pogonion point'. The movements were analysed on the following axis: x - medial-lateral, y - vertical, z - antero-posterior. Significative differences were found in CGxGART - unassisted maximal mouth opening and closing projection on y-axis (OCY), CGxGMYO - unassisted maximal mouth opening and closing projection on x-axis (OCX), and in the measures Opening lateral deviation on x-axis (OLDX), closing lateral deviation on x-axis (CLDX) and in the measures of speed for both. In regard to GARTxGMYO, a significative difference was found in Protrusion lateral deviation on x-axis (PLDX) 'Conover-Iman Test of Multiple Comparisons Using Rank Sums' using Bonferroni correction (P < 0·05). In conclusion, the total opening movements in individuals with TMD tended to have higher deviation than in those asymptomatic individuals and a reduction in the speed of movements.

摘要

当口颌系统的任何组成部分出现功能障碍时,可能会引发颞下颌关节紊乱病(TMD)。本研究的目的是比较无症状参与者与患有TMD的参与者之间下颌运动的偏差、位移和执行速度。采用便利抽样法;根据颞下颌关节紊乱病研究诊断标准经临床评估确诊的40名参与者被分为三组:关节病组(GART,10名参与者,40%为男性)、肌病组(GMYO,10名参与者,30%为男性)和对照组(CG,20名无症状参与者,25%为男性)。要求参与者进行自由最大开口和闭口、左右侧方运动以及伴有牙齿滑动接触的前伸运动。使用光电设备记录下颌轨迹,该设备跟踪放置在“软组织颏前点”前方的反光标记。在以下轴上分析运动:x轴 - 内外侧,y轴 - 垂直,z轴 - 前后。发现在CG与GART组之间 - 无辅助最大开口和闭口在y轴上的投影(OCY)、CG与GMYO组之间 - 无辅助最大开口和闭口在x轴上的投影(OCX),以及在x轴上的开口侧方偏差(OLDX)、闭口侧方偏差(CLDX)测量值以及两者的速度测量值方面存在显著差异。关于GART与GMYO组,在x轴上的前伸侧方偏差(PLDX)方面使用Bonferroni校正的“使用秩和的Conover - Iman多重比较检验”发现存在显著差异(P < 0·05)。总之,患有TMD的个体的总开口运动往往比无症状个体具有更高的偏差,并且运动速度降低。

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