Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China.
Department of Statistics, School of Mathematics, Southwest Jiaotong University,611756, China.
J Stomatol Oral Maxillofac Surg. 2023 Feb;124(1S):101285. doi: 10.1016/j.jormas.2022.09.006. Epub 2022 Sep 7.
Temporomandibular disorder (TMD) symptoms were found to be common in the patients with maxillofacial deformities. The mandibular structure was in relation with the stress within temporomandibular joint (TMJ). However, the current studies on the TMJ stresses in the patients with different maxillofacial deformities are not comprehensive enough.
The aim of this study was to investigate the compression and morphology of the TMJ in the patients with different maxillofacial deformities under central occlusion.
24 patients and 10 asymptomatic individuals were included in this study and divided into patient groups and control group. The 3D models were reconstructed. Muscle forces and boundary conditions corresponding to the central occlusion were applied. Nine morphological parameters of mandible were evaluated.
The minimum principal stresses in the articular disc and condyle were significantly greater than those of the control group (P<0.05). For the articular disc, the compression on the non-deviation side was greater than those on the deviation side in patients with asymmetrical mandibles. There was difference between both sides in the mandibular prognathism and retrusion groups. The joint space of patients was significantly lower than that of the control group (P<0.05).
Maxillofacial deformities might change the condylar position within the articular fossa, which decreased the joint space and increased the compression within TMJ. The patients with asymmetry mandible suffered greater pressure within TMJ on the non-deviation side. The bilaterally over-developed and under-developed mandible in patients might also increase the compression within TMJ.
颞下颌关节紊乱(TMD)症状在颌面畸形患者中较为常见。下颌结构与颞下颌关节(TMJ)内的应力有关。然而,目前对于不同颌面畸形患者 TMJ 内应力的研究还不够全面。
本研究旨在探讨正中咬合下不同颌面畸形患者 TMJ 的压缩和形态。
本研究纳入 24 例患者和 10 例无症状个体,分为患者组和对照组。重建 3D 模型。施加与正中咬合相对应的肌肉力和边界条件。评估下颌的 9 个形态学参数。
关节盘和髁突的最小主应力明显大于对照组(P<0.05)。对于不对称性下颌的患者,关节盘在非偏斜侧的压缩大于偏斜侧。下颌前突和后缩组两侧之间存在差异。患者的关节间隙明显低于对照组(P<0.05)。
颌面畸形可能改变髁突在关节窝内的位置,从而减少关节间隙并增加 TMJ 内的压缩。不对称性下颌的患者 TMJ 内承受更大的压力。患者双侧过度发育和发育不足的下颌也可能增加 TMJ 内的压缩。