Department of Temporomandibular Joint Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou 510000, China.
Department of Temporomandibular Joint Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou 510000, China.
J Stomatol Oral Maxillofac Surg. 2024 Sep;125(5S1):101940. doi: 10.1016/j.jormas.2024.101940. Epub 2024 Jun 8.
The authors retrospectively studied the relationship between the morphology and position of the articular disc in magnetic resonance imaging (MRI) and the morphology and position of the condyle in cone beam computed tomography (CBCT), with the purpose for providing reference for clinical diagnosis and treatment of temporomandibular disorders (TMD).
Patients with both CBCT and MRI imaging data were studied retrospectively, excluding TMJ tumour, fracture, severe condylar morphological abnormalities, non-intercuspal position, and poor quality images. A total of 744 temporomandibular joints (TMJs) from 372 patients were included, with the mean age of 25.94±11.04Y (75 males and 297 females). T2-weighted image (T2WI) of MRI imagings were used to evaluate disc morphology and disc displacement, while CBCT was obtained to evaluate the condylar bone and sagittal condylar position. Data were analysed by Pearson Chi square test and Spearman correlation coefficient.
THE DISTRIBUTION OF 744 TMJS IS AS FOLLOWS: 1) DISC MORPHOLOGY: contracture (37.1 %) > biconcave (32.9 %) > irregular (18.5 %) > lengthened (11.4 %); 2) disc position: ADDWoR (48.3 %) > NA (26.9 %) > ADDWR (21.6 %) > PDDWR (2.8 %) > PDDWoR (0.4 %); 3) condylar position: concentric (43.7 %) > posterior (37.6 %) > anterior (18.7 %); 4) condylar bone: normal (63.4 %)> abnormal (36.6 %). There were significant differences in the distribution of disc morphology and disc position between the sex (P < 0.05). There were significant differences in the distribution of disc position and condylar morphology amongst the age groups (P < 0.05). There were significant differences in the distribution of disc position, condylar position and condylar morphology amongst disc morphology (P < 0.05), and there were positive correlation between disc position(r = 0.703, P = 0.000), the score of condyle (r = 0.478, P = 0.000) and disc morphology respectively. There were significant differences in the distribution of disc position and condylar position amongst condylar morphology (P < 0.05). There was a positive correlation between disc position and condyle morphology (r = 0.413, P = 0.000), and a negative correlation between condyle position and condyle morphology (r=-0.152, P = 0.000). There were significant differences in the distribution of disc position amongst condylar position (P < 0.05), but there was no linear correlation (P = 0.159).
The mutual distribution of disc morphology, disc position, condylar morphology and condylar position was statistically significant. Disc displacement did not necessarily lead to condylar bone changes, but 92.7 % TMJs with condylar bone abnormalities had disc displacement.
This study was retrospectively registered on 28/03/2022 and endorsed by the Ethics committee (LCYJ2022014).
作者回顾性研究了磁共振成像（MRI）中关节盘形态和位置与锥形束计算机断层扫描（CBCT）中髁突形态和位置之间的关系，旨在为颞下颌关节紊乱病（TMD）的临床诊断和治疗提供参考。
回顾性研究同时具有 CBCT 和 MRI 影像学数据的患者，排除 TMJ 肿瘤、骨折、严重髁突形态异常、非正中关系位和图像质量差。共纳入 372 例患者的 744 个 TMJ，平均年龄 25.94±11.04Y（男 75 例，女 297 例）。MRI 的 T2 加权图像（T2WI）用于评估盘形态和盘移位，而 CBCT 用于评估髁突骨和矢状髁突位置。数据采用 Pearson Chi 平方检验和 Spearman 相关系数进行分析。
744 个 TMJ 的分布如下：1）盘形态：挛缩（37.1%）>双凹（32.9%）>不规则（18.5%）>拉长（11.4%）；2）盘位置：ADDWoR（48.3%）>NA（26.9%）>ADDWR（21.6%）>PDDWR（2.8%）>PDDWoR（0.4%）；3）髁突位置：同心（43.7%）>后移（37.6%）>前移（18.7%）；4）髁突骨：正常（63.4%）>异常（36.6%）。盘形态和盘位置的分布在性别间有显著差异（P<0.05）。盘位置和髁突形态的分布在年龄组间有显著差异（P<0.05）。盘形态、髁突位置和髁突形态的分布在盘位置之间有显著差异（P<0.05），盘位置与髁突评分之间存在正相关（r=0.703，P=0.000），与盘形态之间存在正相关（r=0.478，P=0.000）。盘位置和髁突位置的分布在髁突形态间有显著差异（P<0.05）。盘位置与髁突形态之间存在正相关（r=0.413，P=0.000），髁突位置与髁突形态之间存在负相关（r=-0.152，P=0.000）。髁突位置的分布在髁突位置间有显著差异（P<0.05），但无线性相关（P=0.159）。
盘形态、盘位置、髁突形态和髁突位置的相互分布具有统计学意义。髁突骨改变不一定导致盘移位，但 92.7%的髁突骨异常 TMJ 存在盘移位。
本研究于 2022 年 3 月 28 日进行回顾性注册，并得到伦理委员会（LCYJ2022014）的认可。
