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外科正畸治疗后严重骨性II类错牙合髁突位置变化的评估。

Assessment of condylar positional changes in severe skeletal class II malocclusion after surgical-orthodontic treatment.

作者信息

Yang Wen, Chen Yanbin, Li Jiaxuan, Jiang Nan

机构信息

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China, 14 Third Section, Renmin South Road, Chengdu, 610041, Republic of China.

Sichuan University, 14 Third Section, Renmin South Road, Chengdu, 610041, Republic of China.

出版信息

Clin Oral Investig. 2023 Jul;27(7):3683-3693. doi: 10.1007/s00784-023-04984-6. Epub 2023 Apr 5.

Abstract

OBJECTIVES

This study aimed to determine the positional changes in the condyle in the temporomandibular joint (TMJ) of severe skeletal class II malocclusion patients treated with surgical-orthodontics.

MATERIALS AND METHODS

The measurements of TMJ space in 97 severe skeletal class II malocclusion patients (20 males, 77 females, mean age, 24.8 years, mean ANB = 7.41°) were assessed using limited cone-beam computed tomography (LCBCT) images acquired before orthodontics (T0) and 12 months after surgery (T1). 3D remodeling of the TMJ and measurements of the anterior space (AS), superior space (SS), and posterior space (PS) were performed to determine the position of the condyle for each joint. All data were analyzed by t test, correlation analysis, and Pearson correlation coefficient.

RESULTS

The mean AS, SS, and PS values after the therapy changed from 1.684 to 1.680 mm (0.24%), 3.086 to 2.748 mm (10.968%), and 2.873 to 2.155 mm (24.985%), respectively. The decreases in SS and PS were statistically significant. Positive correlations were found in the mean AS, SS, and PS values between the right and left sides.

CONCLUSIONS

The combination of orthodontic and surgical treatment makes the condyle move counterclockwise in the TMJ in severe skeletal class II patients.

CLINICAL RELEVANCE

Studies of temporomandibular joint (TMJ) intervals changes in patients with severe skeletal class II after sagittal split ramus osteotomy (SSRO) are limited. The postoperative joint remodeling, resorption, and related complications remain unstudied.

摘要

目的

本研究旨在确定接受外科正畸治疗的严重骨性II类错牙合患者颞下颌关节(TMJ)中髁突的位置变化。

材料与方法

使用正畸治疗前(T0)和术后12个月(T1)获取的有限锥形束计算机断层扫描(LCBCT)图像,评估97例严重骨性II类错牙合患者(20例男性,77例女性,平均年龄24.8岁,平均ANB = 7.41°)的TMJ间隙。对TMJ进行三维重建,并测量前间隙(AS)、上间隙(SS)和后间隙(PS),以确定每个关节中髁突的位置。所有数据均采用t检验、相关性分析和Pearson相关系数进行分析。

结果

治疗后平均AS、SS和PS值分别从1.684 mm变为1.680 mm(0.24%)、3.086 mm变为2.748 mm(10.968%)和2.873 mm变为2.155 mm(24.985%)。SS和PS的减小具有统计学意义。左右两侧的平均AS、SS和PS值之间存在正相关。

结论

正畸与外科治疗相结合使严重骨性II类患者的髁突在TMJ中逆时针移动。

临床意义

关于严重骨性II类患者矢状劈开下颌支截骨术(SSRO)后颞下颌关节(TMJ)间隙变化的研究有限。术后关节重塑、吸收及相关并发症仍未得到研究。

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