Tagawa Daniella Torres, Franco Alexandre de Albuquerque, Puchnick Andrea, Wolosker Angela Maria Borri, Florez Bruna Maluza, Dominguez Gladys Cristina, Yamashita Helio Kiitiro, Cevidanes Lucia Helena Soares, Aidar Luis Antonio de Arruda, Junior Henrique Carrete
Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Department of Orthodontics, Universidade Santa Cecília, Santos, Brazil.
Orthod Craniofac Res. 2023 May;26(2):185-196. doi: 10.1111/ocr.12599. Epub 2022 Aug 10.
To compare the position and shape of the temporomandibular joint (TMJ) articular disc among the sagittal and vertical skeletal patterns in Angle Class III, Class III subdivision malocclusion and normal occlusion. The null hypothesis was that there was no difference in disc position and shape in different (1) malocclusions and (2) skeletal patterns.
This cross-sectional observational study evaluated 105 patients divided into 3 groups: Class III (33, 9.39 ± 1.96 years), Class III subdivision (45, 9.51 ± 1.59 years) and a normal occlusion (27, 10.24 ± 0.87 years) was included as healthy control. Severity of the maxilla-mandibular anteroposterior discrepancy and vertical facial pattern were determined using 2D cephalometry, and the position and shape of the articular discs were evaluated in magnetic resonance images. Statistical parametric and non-parametric tests and Kappa analysis for intra-observer and inter-observer assessment were used (p ≤ .05).
Significant between-group differences were found in articular disc position. In the normal occlusion group, all the articular discs were well positioned. In Class III and Class III subdivision, the discs were displaced in 30.3% and 12.2% of the TMJs, respectively. Sagittal and vertical skeletal patterns did not affect the findings significantly. The Class III subdivision malocclusion group is probably different from the other groups, showing 97.7% of biconcave discs in both TMJs.
The longitudinal follow-up of this sample becomes relevant as the two groups with malocclusion in the pre-peak phase of pubertal growth showed differences in the prevalence of displacement and form of the articular disc, with no association with their vertical facial characteristics.
比较安氏III类、III类亚类错牙合及正常牙合矢状和垂直骨骼型中颞下颌关节（TMJ）关节盘的位置和形态。无效假设为不同（1）错牙合类型和（2）骨骼型的关节盘位置和形态无差异。
本横断面观察性研究评估了105例患者，分为3组：III类（33例，9.39±1.96岁）、III类亚类（45例，9.51±1.59岁），纳入正常牙合（27例，10.24±0.87岁）作为健康对照。采用二维头影测量法确定上颌-下颌前后向差异和垂直面部型的严重程度，并在磁共振图像上评估关节盘的位置和形态。使用统计参数和非参数检验以及观察者内和观察者间评估的Kappa分析（p≤0.05）。
关节盘位置存在显著组间差异。在正常牙合组中，所有关节盘位置良好。在III类和III类亚类组中，TMJ中分别有30.3%和12.2%的关节盘移位。矢状和垂直骨骼型对结果无显著影响。III类亚类错牙合组可能与其他组不同，其双侧TMJ中97.7%的关节盘呈双凹形。
由于处于青春期生长高峰前期的两个错牙合组在关节盘移位患病率和形态上存在差异，且与垂直面部特征无关，因此对该样本进行纵向随访具有重要意义。
