Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.
National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & NHC Key Laboratory of Digital Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Beijing, 100081, China.
BMC Oral Health. 2024 Apr 17;24(1):467. doi: 10.1186/s12903-024-04219-4.
The temporomandibular joint (TMJ) is closely related to the dynamic balance and stability of mandibular function and orthodontic treatment. Skeletal class II female patients are thought to be at high risk for TMJ disease. The relationship between the TMJ and craniofacial structures is still controversial. This study compared the morphology and position of the TMJ in skeletal class II adolescents and adults with various vertical facial types using cone-beam computed tomography (CBCT).
A total of 117 skeletal class II patients were divided into three groups according to the FH-GoGn angle (hypodivergent, normodivergent and hyperdivergent), with 40 class I normodivergent patients serving as controls. Each group contained two age subgroups (adolescents: 11-14 years old, adults: 18-35 years old). The size (condylar length, height, long and short axis diameter, glenoid fossa width and depth) and shape (condylar neck inclination, condylar head angle and long axis angle, articular eminence inclination) of the condyle and fossa, joint space (anterior, superior, posterior, mesial and lateral), and position of the fossa (vertical, transverse, and anteroposterior distance) and condyle were measured and compared using CBCT.
Class II hypodivergent patients exhibited the greatest condylar length, height, and long- and short-axis diameter; steepest articular eminence; deepest fossa depth; largest superior, mesial and lateral joint spaces; and highest fossa position in both age groups. The manifestations of class II hyperdivergent patients were mostly the opposite. In adults, except for the condylar long axis angle, the measurements of the condyle increased differently among skeletal patterns, while the measurements of the fossa decreased, as the joint spaces and fossa position remained approximately stable compared with those in adolescents.
The vertical skeletal pattern, rather than the class II sagittal skeletal pattern, may be the main factor affecting the morphology and position of the TMJ. Attention should be given to the TMJ area in hyperdivergent patients with a relatively poor-fit condyle-fossa relationship. The changes in the TMJ with age were mainly morphological rather than positional and varied with skeletal pattern.
颞下颌关节（TMJ）与下颌功能的动态平衡和稳定性密切相关，也是正畸治疗的关键。女性骨性 II 类患者被认为是 TMJ 疾病的高危人群。TMJ 与颅面结构的关系仍存在争议。本研究通过锥形束 CT（CBCT）比较了不同垂直面型的骨性 II 类青少年和成人的 TMJ 形态和位置。
共纳入 117 例骨性 II 类患者，根据 FH-GoGn 角（低角、均角和高角）分为三组，其中 40 例 I 类均角患者作为对照组。每组分为青少年组（11-14 岁）和成年组（18-35 岁）。使用 CBCT 测量并比较髁突的大小（髁突长度、高度、长轴和短轴直径、关节窝宽度和深度）和形态（髁突颈倾斜度、髁突头部角度和长轴角度、关节结节倾斜度）、关节间隙（前、上、后、内、外侧）和关节窝位置（垂直、横向和前后距离）及髁突位置。
在两个年龄组中，低角组患者的髁突长度、高度和长、短轴直径最大，关节结节最陡，关节窝深度最深，关节间隙（上、内、外侧）最大，关节窝位置最高。高角组患者的表现则相反。在成年组中，除了髁突长轴角度外，随着关节间隙和关节窝位置基本保持稳定，不同骨型患者的髁突测量值不同，而关节窝测量值减小。
垂直骨骼形态而不是 II 类矢状骨骼形态可能是影响 TMJ 形态和位置的主要因素。对于髁突-关节窝关系不太匹配的高角患者，应注意 TMJ 区域。TMJ 随年龄的变化主要是形态上的而不是位置上的，并且随骨骼形态而变化。
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