术前正畸对骨性Ⅲ类错颌患者颞下颌关节影响的锥形束CT研究

目的 探讨术前正畸对行正畸-正颌联合治疗的骨性Ⅲ类错颌患者颞下颌关节（TMJ）的影响。方法 选取24例行正畸-正颌联合治疗的骨性Ⅲ类错颌患者,分别在术前正畸完成前后检查并记录关节症状,并行锥形束CT（CBCT）扫描,在三维方向测量髁突各径值（d）、髁突高度（h）、不同角度下关节间隙（L）、双侧髁突间距（R）及各髁突角度值,比较和分析不同时期TMJ症状及骨性结构的变化情况。结果 术前正畸前后关节症状无明显改变;颞下颌关节骨性结构在三维方向上的各测量指标均无显著变化（P>0.05）。结论 在正畸-正颌联合治疗过程中,术前正畸不会对患者TMJ产生明显影响。

Investigating the effect of pre-surgical orthodontic treatment on temporomandibular joint in patients with skeletal class Ⅲ malocclusion by cone-beam computed tomography

Objective To investigate the effect of pre-surgical orthodontic treatment on temporomandibular joint (TMJ) in patients with skeletal class Ⅲ malocclusion treated with orthodontic-orthognathic surgical treatment. Methods Twenty-four patients with skeletal class Ⅲ malocclusion who underwent orthodontic-orthognathic surgical treatment were included in the study. Before and after the completion of orthodontic treatment, the symptoms of TMJ were examined and recorded, and the short- and the long-axis diameter of the condylar (d), condylar height (h), joint space (L) at different angles, bilateral condylar spacing (R), and the condylar angles were measured, with scanning performed by using cone-beam computed tomography (CBCT). Then, the changes of TMJ symptoms and bone structure at different periods were analyzed. Results No significant changes were observed in the joint symptoms before and after the pre-surgical orthodontic treatment. No significant changes were found in the measurements of the bone structure of TMJ in the dimensional direction (P>0.05). Conclusion In the orthodontic-orthognathic surgical treatment procedure, the pre-surgical orthodontic process does not have a significant effect on TMJ.