Yan Li, Zhou Maoqiang, Qiu Jiaxuan
Dept. of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
Hangzhou Youqi Dental Clinic, Hangzhou 310016, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2022 Jul 25;40(4):414-421. doi: 10.7518/hxkq.2022.04.007.
To analyze the association between sagittal temporomandibular joint (TMJ) disc position of patients with anterior disc displacement evaluated by magnetic resonance imaging (MRI) and bone morphology of the TMJ evaluated by cone-beam computed tomography (CBCT).
One hundred and seventy-eight TMJs of 97 patients were retrospectively analyzed. The TMJ disc position was evaluated using MRI and classified into four types: control group (without disc displacement), slight group (disc slightly anteriorly displaced), moderate group (disc moderately anteriorly displaced), and severe group (disc severely anteriorly displaced). The measurements of TMJ bone morphology among four groups were evaluated by CBCT through Mimics software including condyle linear dimensions (condyle length, width, and height), condylar volume and surface area, and the depth and length of the glenoid fossa, joint anterior space, joint superior space, and joint posterior space. The sagittal plane position of the condyle was also assessed. The differences in all the morphologic measurement parameters among the four groups were detected using the one-way analysis of variance or the Kruskal Wallis test, and Chi-square tests. The correlations between disc sagittal position and all the morphologic measurements were also analyzed.
There were significant differences in measurements of condyle linear dimensions, condylar volume and surface area, depth of the glenoid fossa, joint spaces, and distribution of the condyle sagittal positions among the four groups. By contrast, there were no statistical differences in terms of the length of the glenoid fossa among the four groups. Correlation analysis revealed that there is a statistically significant negative correlation among condyle linear dimensions, condylar volume and surface area, the depth of the glenoid fossa, joint superior space, and disc position. However, joint posterior space was positively correlated with disc position.
A statistically significant correlation was determined between TMJ bone morphology and different sagittal disc positions. Degenerative changes in TMJ bone morphology clinically diagnosed should be altered, which can be the patients' marker of anterior disc displacement.
分析通过磁共振成像(MRI)评估的前盘移位患者的颞下颌关节(TMJ)矢状位盘位置与通过锥形束计算机断层扫描(CBCT)评估的TMJ骨形态之间的关联。
回顾性分析97例患者的178个TMJ。使用MRI评估TMJ盘位置并分为四种类型:对照组(无盘移位)、轻度组(盘轻度向前移位)、中度组(盘中度向前移位)和重度组(盘严重向前移位)。通过CBCT经Mimics软件评估四组之间TMJ骨形态的测量值,包括髁突线性尺寸(髁突长度、宽度和高度)、髁突体积和表面积,以及关节窝的深度和长度、关节前间隙、关节上间隙和关节后间隙。还评估了髁突的矢状面位置。使用单因素方差分析或Kruskal Wallis检验以及卡方检验检测四组之间所有形态学测量参数的差异。还分析了盘矢状位与所有形态学测量值之间的相关性。
四组之间在髁突线性尺寸、髁突体积和表面积、关节窝深度、关节间隙以及髁突矢状位分布的测量值上存在显著差异。相比之下,四组之间关节窝长度无统计学差异。相关性分析显示,髁突线性尺寸、髁突体积和表面积、关节窝深度、关节上间隙与盘位置之间存在统计学显著负相关。然而,关节后间隙与盘位置呈正相关。
确定了TMJ骨形态与不同矢状位盘位置之间存在统计学显著相关性。临床诊断的TMJ骨形态退变变化应有所改变,这可能是前盘移位患者的标志。