Yang Luyuan, Xie Yu, Guo Ruiming, Li Xueyuan, Li Songhang
State Key Laboratory of Oral Diseases, Department of Oral Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China.
Department of Oral Implantology, Shanghai Ninth People's Hospital, Shanghai Perio-Implant Innovation Center, Shanghai Jiao Tong University, Shanghai, China.
Clin Oral Investig. 2025 Apr 8;29(5):230. doi: 10.1007/s00784-025-06299-0.
Current cone beam computed tomography (CBCT) methods cannot demonstrate the temporomandibular joint fossa-condyle relationship in real time. This study aimed to print a simple guide plate with marker points and capture a single CBCT scan based on positional changes of the marker points to align the maxilla and mandible positions.
The three groups were divided into the intercuspal position, 5 mm unilateral elevation, and 10 mm bilateral elevation to simulate different patient occlusal situations after treatment. The maxillary and mandibular positions were aligned according to points marked on the reference plate. Then, the deviation was compared between the three-dimensional images obtained employing this method and those reconstructed from CBCT. A one-way analysis of variance was conducted, and post hoc analyses were performed using the Tamhane's T2 multiple comparison test (α = 0.05).
The intercuspal position had a mean deviation value of - 0.1313 with an RMS of 0.4411. The unilateral elevation had a mean deviation value of 0.3253 with an RMS of 1.2707. The bilateral elevation had a mean deviation value of - 0.0537 with an RMS of 1.281. There were no statistical differences among the three groups at α = 0.05.
This method can reduce the number of CBCT scans to one and predict the relative positions of the maxilla and mandible when changes in joint position occur from occlusion. This method can increase the accuracy of treatment, assist novice doctors to adjust the occlusal height, provide a visual means to extract and verify the treatment effect, reduce the number of diagnoses and treatments to a certain extent, reduce the radiation damage during treatment, and can be better applied to the chair side, providing convenience for patients and doctors.
The method described in this study used a face scan, reference plate, and the first CBCT of the participant combined with 3D reconstruction to clinically observe the temporomandibular joint. This method can reduce the number of CBCT scans required, amount of radiation exposure, patient burden, and number of clinic visits while increasing the comfort level of patients.
当前的锥形束计算机断层扫描（CBCT）方法无法实时显示颞下颌关节窝-髁突关系。本研究旨在打印带有标记点的简单导板，并根据标记点的位置变化进行单次CBCT扫描，以对齐上颌和下颌位置。
将三组分为牙尖交错位、单侧抬高5毫米和双侧抬高10毫米，以模拟治疗后不同患者的咬合情况。根据参考板上标记的点对齐上颌和下颌位置。然后，比较采用该方法获得的三维图像与从CBCT重建的三维图像之间的偏差。进行单因素方差分析，并使用Tamhanes T2多重比较检验进行事后分析（α = 0.05）。
牙尖交错位的平均偏差值为-0.1313，均方根（RMS）为0.4411。单侧抬高的平均偏差值为0.3253，RMS为1.2707。双侧抬高的平均偏差值为-0.0537，RMS为1.281。在α = 0.05时，三组之间无统计学差异。
该方法可将CBCT扫描次数减少至一次，并在关节位置因咬合发生变化时预测上颌和下颌的相对位置。该方法可提高治疗准确性，协助新手医生调整咬合高度，提供直观手段以提取和验证治疗效果，在一定程度上减少诊断和治疗次数，减少治疗期间的辐射损伤，且可更好地应用于椅旁，为患者和医生提供便利。
本研究中描述的方法使用面部扫描、参考板以及参与者的首次CBCT结合三维重建来临床观察颞下颌关节。该方法可减少所需的CBCT扫描次数、辐射暴露量、患者负担和门诊就诊次数，同时提高患者的舒适度。
