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颞下颌关节骨改建患者的影像学和临床表现相关性研究。

Association of radiographic and clinical findings in patients with temporomandibular joints osseous alteration.

机构信息

Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok, 10400, Thailand.

Department of Masticatory Science, Faculty of Dentistry, Mahidol University, 6 Yothi street, Rathevi, Bangkok, 10400, Thailand.

出版信息

Clin Oral Investig. 2020 Jan;24(1):221-227. doi: 10.1007/s00784-019-02945-6. Epub 2019 May 11.

Abstract

OBJECTIVES

To characterize the relationship between radiographic and clinical characteristics of patients with temporomandibular joint (TMJ) osseous changes.

MATERIALS AND METHODS

TMJ cone beam computed tomography (CBCT) images of 73 patients (142 joints) with changes in osseous component of TMJ were included in this study. Based on both clinical and radiographic findings, each TMJ was diagnosed as either non-degenerative joint disease (non-DJD) or degenerative joint disease (DJD) according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) criteria. The DJD group was further classified into two subgroups of osteoarthritis and osteoarthrosis. The data were analyzed using t test and Pearson's correlation. Level of statistical significance was set at 0.05.

RESULTS

Statistically significant relationships were found between TMJ crepitation sound and 4 radiographic characteristics of DJD. DJD group demonstrated statistically significant higher CBCT bone change score (BCS) and age. In contrast, there was no significant difference of BCS between osteoarthrosis and osteoarthritis groups within the DJD group.

CONCLUSIONS

Crepitation sounds and osseous changes in TMJ radiograph are confirmed to be important diagnostic criteria for TMJ DJD. However, degree of TMJ osseous changes does not correlate significantly with clinical pain symptom.

CLINICAL RELEVANCE

For TMJ DJD diagnosis, dentists should consider both clinical examination for TMJ crepitation and radiographic assessment for TMJ bony changes.

摘要

目的

描述颞下颌关节(TMJ)骨改变患者的影像学和临床特征之间的关系。

材料和方法

本研究纳入了 73 例(142 个关节)TMJ 骨成分改变患者的 TMJ 锥形束 CT(CBCT)图像。根据临床和影像学表现,根据颞下颌关节紊乱病诊断标准(DC/TMD),每个 TMJ 被诊断为非退行性关节疾病(非 DJD)或退行性关节疾病(DJD)。DJD 组进一步分为骨关节炎和骨关节炎亚组。使用 t 检验和 Pearson 相关分析对数据进行分析。统计学显著性水平设定为 0.05。

结果

TMJ 弹响与 DJD 的 4 种影像学特征之间存在统计学显著关系。DJD 组的 CBCT 骨改变评分(BCS)和年龄明显更高。相比之下,DJD 组中骨关节炎和骨关节炎亚组之间的 BCS 没有显著差异。

结论

TMJ 影像学上的弹响和骨改变被证实是 TMJ DJD 的重要诊断标准。然而,TMJ 骨改变的程度与临床疼痛症状无显著相关性。

临床相关性

对于 TMJ DJD 的诊断,牙医应同时考虑 TMJ 弹响的临床检查和 TMJ 骨改变的影像学评估。

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