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利用锥形束计算机断层扫描研究咀嚼侧偏斜的颞下颌关节紊乱病患者髁突位置的对比研究。

A comparative study of condyle position in temporomandibular disorder patients with chewing side preference using cone-beam computed tomography.

机构信息

Department of Stomatology, General Hospital of Southern Theater of PLA, Guangzhou, China.

Department of Stomatology, Chinese PLA General Hospital, Beijing, China.

出版信息

J Oral Rehabil. 2022 Feb;49(2):265-271. doi: 10.1111/joor.13293. Epub 2022 Jan 11.

Abstract

BACKGROUND

Chewing side preference (CSP) could cause structural and morphological changes of temporomandibular joint (TMJ) and has been suggested as one aetiology of temporomandibular disorders (TMDs), but the condylar position in TMD patients with CSP is unknown.

OBJECTIVE

To compare the condylar position in the TMD patients with and without CSP.

METHODS

Ninety TMD patients with unilateral symptom (69 with CSP and 21 without CSP) and 20 asymptomatic participants received cone-beam computed tomography. The condylar position was determined based on the measurements of sagittal joint spaces. Intergroup and intra-group comparisons of the condylar position were performed.

RESULTS

The condyles in asymptomatic participants located nearly randomly in anterior, centric and posterior positions. Patients without CSP had significantly more posterior condyles than asymptomatic participants (57.1% vs 30.0%, p < 0.05). In patients with CSP, 50.7% of the condyles on the preferred chewing side and 42.0% on the unpreferred side located posteriorly, reaching no significant level compared with the asymptomatic participants and patients without CSP (p > 0.05). The symptomatic joints and asymptomatic joints in patients with CSP and without CSP showed no significant differences in condylar position. While patients without CSP had significantly more posterior condyles in symptomatic joints than asymptomatic participants (p < 0.05), patients with CSP showed a trend towards more posterior condyles in symptomatic joints compared with the asymptomatic participants (53.6% vs 30.0%, p = 0.054).

CONCLUSION

Condylar position is not a strong indicator to differentiate CSP-related TMDs from non-CSP-related TMDs. Posterior condyle could not be viewed as one indicator of TMD.

摘要

背景

咀嚼侧偏斜(CSP)可能导致颞下颌关节(TMJ)的结构和形态改变,并被认为是颞下颌关节紊乱(TMD)的病因之一,但 CSP 伴 TMD 患者的髁突位置尚不清楚。

目的

比较 CSP 伴 TMD 患者与不伴 CSP 伴 TMD 患者的髁突位置。

方法

90 例单侧症状的 TMD 患者(69 例伴 CSP,21 例不伴 CSP)和 20 例无症状参与者接受了锥形束 CT 检查。髁突位置根据矢状关节间隙的测量来确定。比较了组间和组内髁突位置的差异。

结果

无症状参与者的髁突几乎随机位于前位、中位和后位。不伴 CSP 的患者后髁突的比例明显高于无症状参与者(57.1% vs 30.0%,p<0.05)。在 CSP 患者中,50.7%的优势侧髁突和 42.0%的非优势侧髁突位于后位,但与无症状参与者和不伴 CSP 的患者相比,差异无统计学意义(p>0.05)。CSP 患者的患侧关节和无症状关节以及不伴 CSP 的患者的患侧关节和无症状关节的髁突位置无显著差异。不伴 CSP 的患者患侧关节后髁突的比例明显高于无症状参与者(p<0.05),而 CSP 患者患侧关节后髁突的比例与无症状参与者相比有增加的趋势(53.6% vs 30.0%,p=0.054)。

结论

髁突位置不是区分 CSP 相关 TMD 与非 CSP 相关 TMD 的有力指标。后髁突不能作为 TMD 的一个指标。

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