Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Centre of Stomatology, Shanghai, China.
Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Centre of Stomatology, Shanghai, China.
Int J Oral Maxillofac Surg. 2021 May;50(5):665-669. doi: 10.1016/j.ijom.2020.09.027. Epub 2020 Dec 11.
The aim of this study was to investigate the contributing factor of impaired skeletal quality in the pathogenesis of idiopathic condylar resorption (ICR). One hundred and twenty-six patients with MRI-confirmed ICR and 596 patients with disc displacement (DD) without a diminished condyle, of both sexes, were included. Dental examinations and retrospective surveys regarding temporomandibular joint symptoms and progression of maxillofacial deformities were conducted. Skeletal bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DXA) and converted to T-scores and Z-scores. Results showed that ICR patients had a smaller overbite (1.56±3.3 vs 3.05±2.0mm), larger overjet (4.9±2.4 vs 3.5±1.9mm), larger range of mouth opening (36.5±6.7 vs 33.6±7.1mm), and higher rates of anterior open bite and mandibular retrusion compared to DD patients (all P<0.001). ICR was associated with an increased probability of low skeletal BMD at chronological age in females (P=0.020) but not in males (P=0.095). This study indicates that reduced BMD may predispose females to an exacerbated condylar resorption process in addition to increased joint loading initiated from DD.
本研究旨在探讨特发性髁突吸收(ICR)发病机制中骨质量受损的影响因素。纳入 126 名经 MRI 确诊的 ICR 患者和 596 名无髁突萎缩的关节盘移位(DD)患者(男女不限)。进行了口腔检查和颞下颌关节症状及颌面部畸形进展的回顾性调查。通过双能 X 线吸收法(DXA)测量骨骼骨矿物质密度(BMD),并转化为 T 评分和 Z 评分。结果显示,ICR 患者的覆合(1.56±3.3 比 3.05±2.0mm)较小,覆盖(4.9±2.4 比 3.5±1.9mm)较大,张口范围(36.5±6.7 比 33.6±7.1mm)较大,前牙开合和下颌后缩的发生率也高于 DD 患者(均 P<0.001)。与男性(P=0.095)相比,ICR 与女性年龄相关的骨骼 BMD 降低的概率增加相关(P=0.020)。本研究表明,除了由 DD 引起的关节负荷增加之外,低 BMD 可能使女性更容易发生髁突吸收加剧的过程。