Xu Bin, Park Jung-Jin, Kim Seong-Hun
Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea.
Department of Orthodontics, Dental Hospital, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
Korean J Orthod. 2024 Sep 25;54(5):325-341. doi: 10.4041/kjod24.089. Epub 2024 Sep 4.
To correlate temporomandibular joint (TMJ) morphology and position with cone-beam computed tomography (CBCT) images, Joint Vibration Analysis (JVA), and Jaw Tracker (JT) to develop a radiation-free, dynamic method for screening and monitoring the TMJ in orthodontic patients.
A total of 236 orthodontic patients without symptoms of TMJ disorders who had undergone CBCT were selected for the JVA and JT tests in this cross-sectional study. TMJ position and morphology were measured using a three-dimensional analysis software. JT measurements involved six opening-closing cycles, and JVA measurements were performed using a metronome to guide the mouth opening-closing movements of the patients. The correlations among the three measuring devices were evaluated.
Abnormalities in condylar surface morphology affected the mandibular range of motion. The cut-off value results show that when various measurement groups are within a certain range, abnormalities may be observed in morphology (area under the curve, 0.81; < 0.001). A 300/< 300 Hz ratio ≥ 0.09 suggested abnormal morphology ( < 0.05). Correlations were observed among the maximum opening velocity, maximum vertical opening position, and joint spaces in the JT measurements. Correlations were also observed between the > 300/< 300 Hz ratio, median frequency, total integral, integral < 300 Hz, and peak frequency with joint spaces in the JVA measurements.
JT and JVA may serve as rapid, non-invasive, and radiation-free dynamic diagnostic tools for monitoring and screening TMJ abnormalities before and during orthodontic treatment.
将颞下颌关节(TMJ)的形态和位置与锥形束计算机断层扫描(CBCT)图像、关节振动分析(JVA)以及颌骨追踪器(JT)相关联,以开发一种无辐射的动态方法,用于正畸患者颞下颌关节的筛查和监测。
在这项横断面研究中,共选取了236名无颞下颌关节紊乱症状且已接受CBCT检查的正畸患者进行JVA和JT测试。使用三维分析软件测量颞下颌关节的位置和形态。JT测量包括六个开闭周期,JVA测量使用节拍器指导患者的张口-闭口运动。评估三种测量设备之间的相关性。
髁突表面形态异常影响下颌运动范围。截断值结果表明,当各个测量组处于一定范围内时,可能会观察到形态异常(曲线下面积,0.81;P<0.001)。300/<300Hz比值≥0.09提示形态异常(P<0.05)。在JT测量中,观察到最大开口速度、最大垂直开口位置和关节间隙之间存在相关性。在JVA测量中,还观察到>300/<300Hz比值、中频、总积分、积分<300Hz以及峰值频率与关节间隙之间存在相关性。
JT和JVA可作为快速、无创且无辐射的动态诊断工具,用于正畸治疗前和治疗期间颞下颌关节异常的监测和筛查。