Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China.
Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China.
Eur J Radiol. 2023 Dec;169:111189. doi: 10.1016/j.ejrad.2023.111189. Epub 2023 Nov 4.
The objective of this study was to analyze the effect of TMJ disc position on condylar bone remodeling after arthroscopic disc repositioning surgery.
Nine patients with anterior disc displacement without reduction (ADDWoR, 15 sides) who underwent arthroscopic disc repositioning surgery were included. Three-dimensional (3D) reconstruction of the articular disc and the condyle in the closed-mouth position was performed using cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) data. Then, the CBCT and MRI images were fused and displayed together by multimodal image registration techniques. Morphological changes in the articular disc and condyle, as well as changes in their spatial relationship, were studied by comparing preoperative and 3-month postoperative CBCT-MRI fused images.
The volume and superficial area of the articular disc, as well as the area of the articular disc surface in the subarticular cavity, were significantly increased compared to that before the surgical treatment（P < 0.01）. There was also a significant increase in the volume of the condyle (P < 0.001). All condyles showed bone remodeling after surgery that could be categorized as one of two types depending on the position of the articular disc, suggesting that the location of the articular disc was related to the new bone formation.
The morphology of the articular disc and condyle were significantly changed after arthroscopic disc repositioning surgery. The 3D changes in the position of the articular disc after surgery tended to have an effect on condylar bone remodeling and the location of new bone formation.
本研究旨在分析关节镜下盘复位术后颞下颌关节盘位置对髁突骨重塑的影响。
纳入 9 例关节盘不可复性前移位（ADDWoR，15 侧）患者，行关节镜下盘复位术。采用锥形束 CT（CBCT）和磁共振成像（MRI）数据对闭口位关节盘和髁突进行三维（3D）重建。然后，采用多模态图像配准技术将 CBCT 和 MRI 图像融合并一起显示。通过比较术前和术后 3 个月的 CBCT-MRI 融合图像，研究关节盘和髁突的形态变化及其空间关系的变化。
与术前治疗相比，关节盘的体积和表面积以及关节盘在关节下腔的表面面积明显增加（P<0.01）。髁突体积也明显增加（P<0.001）。所有髁突在手术后均发生骨重塑，根据关节盘的位置可分为两种类型之一，表明关节盘的位置与新骨形成有关。
关节镜下盘复位术后关节盘和髁突的形态发生明显变化。术后关节盘位置的 3D 变化可能对髁突骨重塑和新骨形成的位置产生影响。
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