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CBCT评估成人安氏II类错牙合患者颌面部形态对颞下颌关节退行性改变及髁突位置的影响——一项横断面研究

Influence of Maxillofacial Morphology on Temporomandibular Joint Degenerative Alterations and Condyle Position Assessed by CBCT in Class II Malocclusion Adult Patients-A Cross-Sectional Study.

作者信息

Dygas Sebastian, Szarmach Izabela, Radej Ilona, Chaqués-Asensi José

机构信息

Department of Orthodontics, Medical University of Bialystok, 15-274 Bialystok, Poland.

Independent Researcher, 41009 Seville, Spain.

出版信息

J Clin Med. 2025 Jun 25;14(13):4499. doi: 10.3390/jcm14134499.

Abstract

This cross-sectional analytical study investigated the relationship between the craniofacial morphology, condylar displacement, and degenerative changes in the temporomandibular joints (TMJs) in adult patients with class II skeletal malocclusion. To compare cephalometric variables, joint space dimensions, and centric slide measurements between patients with and without CBCT-confirmed TMJ degenerative alterations. Sixty adults with class II malocclusion were divided into two equal groups (n = 30) based on the presence or absence of TMJ degenerative changes on CBCT. Joint spaces were measured, condylar displacement was evaluated using a condylar position indicator (CPI), and cephalometric analysis was performed in both maximal intercuspation and centric relation. Statistical comparisons were performed using -tests, chi-squared tests, and Pearson's correlation analysis. Significance was set at < 0.05. Patients with degenerative TMJ changes exhibited significantly greater overjet ( = 0.0001) and a trend toward increased ANB angles ( = 0.055). The superior joint space was reduced on the right side ( = 0.031). Condylar displacements ≥ 2 mm were more frequent in the affected group and correlated with sagittal cephalometric discrepancies (45% vs. 24% in controls). Aggravated skeletal class II malocclusion with increased overjet could be associated with TMJ degenerative changes. CR-based cephalometry and CBCT evaluation may aid in diagnostic assessment, but longitudinal studies are needed to confirm the clinical relevance.

摘要

这项横断面分析研究调查了成年II类骨骼错牙合患者的颅面形态、髁突移位与颞下颌关节(TMJ)退行性改变之间的关系。比较有和没有CBCT确诊的TMJ退行性改变的患者之间的头影测量变量、关节间隙尺寸和正中滑动测量值。60名II类错牙合的成年人根据CBCT上TMJ退行性改变的有无分为两组(n = 30)。测量关节间隙,使用髁突位置指示器(CPI)评估髁突移位,并在最大牙尖交错位和正中关系位进行头影测量分析。使用t检验、卡方检验和Pearson相关分析进行统计学比较。显著性设定为P < 0.05。有TMJ退行性改变的患者表现出明显更大的覆盖(P = 0.0001)以及ANB角增加的趋势(P = 0.055)。右侧上关节间隙减小(P = 0.031)。受影响组中髁突移位≥2 mm更为常见,并且与矢状位头影测量差异相关(45% 对对照组中的24%)。伴有覆盖增加的严重II类骨骼错牙合可能与TMJ退行性改变有关。基于正中关系的头影测量和CBCT评估可能有助于诊断评估,但需要纵向研究来证实其临床相关性。

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