特发性髁突吸收患者的髁突变化：基于CBCT的2年回顾性病例对照研究。

Condylar changes in patients with idiopathic condylar resorption: retrospective 2-year follow-up CBCT-based case-control study.

作者信息

Exposto Cristina R, Stoustrup Peter, Kristensen Kasper D, Dalstra Michel, Pedersen Thomas K

机构信息

Section of Orthodontics, Department of Dentistry, Health, Aarhus University.

Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Denmark.

出版信息

Eur J Orthod. 2020 Dec 2;42(6):619-625. doi: 10.1093/ejo/cjz099.

DOI:10.1093/ejo/cjz099

PMID:32036384

Abstract

OBJECTIVES

To compare condylar development and changes in condylar radiological appearance in patients with idiopathic condylar resorption (ICR) to a healthy, age- and gender matched, control group.

MATERIALS AND METHODS

This case-control study included 16 ICR patients [mean age: 15years, 9 months; standard deviation (SD): 4 years) and 16 controls (mean age: 16 years, 8 months; SD: 4 years, 7 months), with diagnostic (T0) and 2-year follow-up (T1) CBCT examinations. Condylar changes were evaluated through changes in condylar neck angle (CNA), and the transversal, vertical and anteroposterior displacement of five condylar points between T0 and T1. The magnitude and direction of condylar changes were evaluated using vector analyses. A qualitative radiological evaluation of the TMJ was performed based on healthy, erosive and repaired morphological appearance. Linear and angular measurements were assessed using ANOVA and a Tukey post-hoc test, and vectors were tested using an independent-sample 2-tailed t-test. Fisher's exact test was used for the qualitative evaluation.

RESULTS

At T0, ICR patients exhibited decreased condylar height, smaller condylar width and posteriorly inclined CNA compared with the control group (P < 0.05). During observation, condylar vertical growth was smaller in the ICR group than in the control group (P < 0.05). Vector analysis showed an upward direction of vertical displacement for all condylar points in the control group; the ICR group showed a downward direction (P < 0.003). The radiological appearance of 75% of the ICR condyles and 94% of the control condyles did not change during the 2-year follow-up period.

CONCLUSIONS

ICR condyles displayed reduced vertical development compared with control condyles. The radiological appearance remained unchanged for most joints. Observed changes in radiological appearance did not always follow a progressive model of degenerative joint disease.

摘要

目的

比较特发性髁突吸收（ICR）患者与年龄和性别匹配的健康对照组的髁突发育情况及髁突放射学表现的变化。

材料与方法

本病例对照研究纳入了16例ICR患者（平均年龄：15岁9个月；标准差[SD]：4年）和16例对照组（平均年龄：16岁8个月；SD：4年7个月），进行了诊断性（T0）和2年随访（T1）的锥形束计算机断层扫描（CBCT）检查。通过髁突颈角（CNA）的变化以及T0和T1之间五个髁突点的横向、垂直和前后位移来评估髁突变化。使用向量分析评估髁突变化的大小和方向。基于健康、侵蚀性和修复性形态外观对颞下颌关节进行定性放射学评估。使用方差分析和Tukey事后检验评估线性和角度测量值，使用独立样本双尾t检验测试向量。采用Fisher精确检验进行定性评估。

结果

在T0时，与对照组相比，ICR患者的髁突高度降低、髁突宽度较小且CNA向后倾斜（P<0.05）。在观察期间，ICR组的髁突垂直生长小于对照组（P<0.05）。向量分析显示，对照组所有髁突点的垂直位移方向向上；ICR组显示向下方向（P<0.003）。在2年随访期间，75%的ICR髁突和94%的对照髁突的放射学表现未发生变化。