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颞下颌关节盘前移位与皮质化模式。

Anterior Disc Displacement and Cortication Patterns in the Temporomandibular Joint.

机构信息

Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Harran University, Sanliurfa, Turkey.

出版信息

Med Sci Monit. 2024 Oct 5;30:e945967. doi: 10.12659/MSM.945967.

Abstract

BACKGROUND Anterior reduction disc displacement (ARDD) of the temporomandibular joint (TMJ) can present with pain and clicking of the jaw when chewing. This study aimed to evaluate the relationship between articular eminence cortication (AEC) and mandibular condyle cortication (MCC) in 81 patients with ARDD of the TMJ using cone beam computed tomography (CBCT) imaging. MATERIAL AND METHODS We examined images of 142 patients who applied to the outpatient clinic between 2022 and 2024 for various reasons and whose radiographic records included CBCT and MRI images. Sixty-one patients who did not meet the inclusion criteria were excluded from the study. MRI images of the remaining 81 patients were analyzed and evaluated for the presence of ARDD. Subsequently, all mandibular condylar processes and articular eminences included in the study were examined by CBCT and the degree of cortication was classified and noted. The relationship between MCC and AEC and ARDD was evaluated with the SPSS 23.0 program (SPSS, Chicago, IL, USA). RESULTS ARDD was observed in 46 (28.4%) of 162 condyles examined. Type 1 cortications were observed in 8 (17.4%), type 2 in 36 (78.3%), and type 3 in 2 (4.3%) of the condyles with disc displacement; 80.0% (8) of type 2 cortications were found in patients with ARDD (P<0.001), and 75.0% of type 3 cortication was observed in intact condyles (P<0.001). CONCLUSIONS This study shows that loss of AEC and MCC may be a significant factor in the diagnosis of ARDD, and decreased AEC and MCC may be a criterion for the diagnosis of ARDD.

摘要

背景

颞下颌关节(TMJ)的前移位性盘前移位(ARDD)在咀嚼时会出现下颌疼痛和弹响。本研究旨在使用锥形束 CT(CBCT)成像评估 81 例 TMJ ARDD 患者关节突皮质化(AEC)和髁突皮质化(MCC)之间的关系。

材料与方法

我们检查了 2022 年至 2024 年期间因各种原因就诊于门诊的 142 例患者的影像学资料,这些患者的影像学记录均包括 CBCT 和 MRI 图像。将 61 例不符合纳入标准的患者排除在研究之外。对其余 81 例患者的 MRI 图像进行分析和评估,以确定是否存在 ARDD。随后,通过 CBCT 检查包括在研究中的所有下颌髁突和关节突,并对皮质化程度进行分类和记录。使用 SPSS 23.0 程序(SPSS,芝加哥,IL,美国)评估 MCC 和 AEC 与 ARDD 之间的关系。

结果

在检查的 162 个髁突中,46 个(28.4%)存在 ARDD。在有盘前移位的髁突中,1 型皮质化分别有 8 个(17.4%),2 型皮质化有 36 个(78.3%),3 型皮质化有 2 个(4.3%);2 型皮质化中,80.0%(8 个)见于 ARDD 患者(P<0.001),3 型皮质化中,75.0%见于完整髁突(P<0.001)。

结论

本研究表明,AEC 和 MCC 的丧失可能是 ARDD 诊断的一个重要因素,AEC 和 MCC 的减少可能是 ARDD 的诊断标准之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ce4/11463101/5f5c4e3602a8/medscimonit-30-e945967-g001.jpg

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