Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Cukurova University, Adana, Turkey.
Department of Neurology, Faculty of Medicine, Cukurova University, Adana, Turkey.
J Oral Rehabil. 2023 Oct;50(10):958-964. doi: 10.1111/joor.13533. Epub 2023 Jun 16.
Myotonic dystrophy type 1 (DM1) is a neuromuscular multisystem disease. Early involvement of facial muscles may produce an extra load on the temporomandibular joint (TMJ) in DM1.
This study aimed to investigate the morphological analyses of the bone components of temporomandibular joint (TMJ), and dentofacial morphology in myotonic dystrophy type 1 (DM1) patients by cone-beam computed tomography (CBCT).
Sixty-six individuals (33 DM1, and 33 healthy subjects) age ranging from 20 to 69 were included in the study. Clinical examinations of the patients' TMJ regions and evaluation of dentofacial morphology (maxillary deficiency, open-bite, deep palate and cross-bite) were performed. Dental occlusion was determined based on Angle's classification. CBCT images were evaluated regarding mandibular condyle morphology (convex, angled, flat and round) and osseous changes observed in the condyle (normal, osteophyte, erosion, flattening, sclerosis). DM1-specific morphological and bony TMJ alterations were determined.
DM1 patients showed a high prevalence of morphological and osseous TMJ changes, and statistically significant skeletal alterations. The analysis of CBCT scans indicated the prevalent condylar shape among patients with DM1 was flat, the main osseous abnormality was flattening, there was a tendency towards skeletal Class II and a posterior cross-bite was frequently detected in DM1 patients. There was no statistically significant difference between the genders on the parameters evaluated in both groups.
Adult patients with DM1 presented a high frequency of crossbite, tendency to skeletal Class II and morphological osseous alterations of TMJ. The analysis of the morphological condylar alterations in patients with DM1 may be beneficial in the diagnosis of TMJ disorders. This study reveals DM1-specific morphological and osseous TMJ alterations to provide an appropriate orthodontic/orthognathic treatment planning to patients.
1 型肌强直性营养不良（DM1）是一种神经肌肉多系统疾病。面部肌肉的早期受累可能会给颞下颌关节（TMJ）带来额外的负担。
本研究旨在通过锥形束 CT（CBCT）研究 1 型肌强直性营养不良（DM1）患者 TMJ 骨成分和牙颌面形态的形态学分析。
本研究纳入了年龄在 20 至 69 岁之间的 66 名个体（33 名 DM1 患者和 33 名健康对照者）。对患者 TMJ 区域进行临床检查，并评估牙颌面形态（上颌骨不足、开颌、深覆颌和反颌）。根据 Angle 分类确定牙咬合情况。通过 CBCT 图像评估下颌髁突形态（凸、角、平、圆）和髁突的骨变化（正常、骨赘、侵蚀、变平、硬化）。确定 DM1 特异性的 TMJ 形态和骨改变。
DM1 患者的 TMJ 形态和骨改变以及骨骼改变的发生率较高，且具有统计学意义。CBCT 扫描分析表明，DM1 患者中常见的髁突形状为平坦，主要的骨异常为变平，存在骨骼 II 类倾向，且经常检测到 DM1 患者的后反颌。在两组评估的参数中，性别之间没有统计学上的显著差异。
成年 DM1 患者经常出现反颌、骨骼 II 类倾向和 TMJ 的形态和骨改变。分析 DM1 患者的形态髁突改变可能有助于 TMJ 疾病的诊断。本研究揭示了 DM1 特异性的 TMJ 形态和骨改变，为患者提供了适当的正畸/正颌治疗计划。
