青春期安氏Ⅱ类1分类患者髁突矢状向位置的锥形束CT测量分析

目的： 应用锥形束CT（CBCT）对青春期安氏Ⅱ类1分类患者的髁突相对于关节窝的矢状向位置进行测量,为Ⅱ类错早期进行下颌前导的功能矫形治疗计划制订提供依据。方法：实验组选用临床无颞下颌关节紊乱症状的青春期安氏Ⅱ类1分类患者40例(男18例,女22例),应用Twin-block功能矫治器进行下颌前导治疗。对照组选用相应年龄阶段骨性安氏I类拥挤、临床无颞下颌关节紊乱症状并存在埋伏阻生牙、需拍摄CBCT的患者44例(男19例,女23例)。2组患者均于治疗前拍摄全头颅CBCT。应用Mimics10.01软件对2组患者关节窝深度、关节窝前壁角度、关节上间隙宽度、关节前间隙宽度及关节后间隙宽度进行测量,应用SPSS15.0软件包对数据进行统计学分析。结果：实验组与对照组患者两侧关节窝深度、关节窝前壁角度、关节上间隙宽度、关节前间隙宽度及关节后间隙宽度均无显著差异（P<0.05）。对安氏Ⅱ类1分类及安氏Ⅰ类对照组2组数据进行配对t检验,显示2组间关节窝深度、关节窝前壁角度及关节上间隙宽度无显著差异（P>0.05）,但关节前间隙宽度及关节后间隙宽度均有显著差异（P<0.05）。结论：青春期安氏Ⅱ类1分类患者与安氏I类患者的关节窝深度、关节窝前壁角度、关节上间隙宽度均无显著差异,但关节前间隙宽度明显减小,而关节后间隙宽度明显增大。该结果提示临床医师在青春期安氏Ⅱ类1分类患者功能矫形治疗前,应考虑患者是否存在髁突的前移代偿。

Evaluation of sagittal temporomandibular condyle position in adolescent Angle Class Ⅱ division 1 patients by cone-beam CT

PURPOSE: To evaluate condyle-fossa relationship and provide some evidences for functional orthopedic treatment in adolescent Angle Class Ⅱ division 1 patients. METHODS: Forty adolescent Angle Class II division 1 patients (18 males, 22 females) who have to temporomandibular symptom were involved in this study and 42 adolescent Angle Class I patients (19 males, 23 females) served as control which had impacted teeth needed to take cone-beam CT (CBCT). Mimics 10.01 software was used to measure the depth of the mandibular fossa, the angulation of the posterior wall of the articular tubercle, anterior joint space, superior joint space, posterior joint space in CBCT imaging. Paired t test was applied for comparison between 2 groups using SPSS 15.0 software package. RESULTS: The measured data on left and right side in both Angle Class Ⅱ division 1 patients and Angle Class I patients had no significant differences (P>0.05). The depth of the mandibular fossa, the angulation of the posterior wall of the articular tubercle, the superior joint space have no significant difference (P>0.05). The anterior joint space decreased significantly (P<0.05) and posterior joint space increased significantly (P<0.05) in adolescent Angle Class Ⅱ division 1 patients compared with adolescent Angle Class ⅠI patients. CONCLUSIONS: In adolescent Angle Class Ⅱ division 1 patients, anterior joint space decreased and posterior joint space increased compared with Angle Class Ⅰpatients. And the condyle may move forward for compensation. Orthodontists should pay attention to condyle-fossa relationship in adolescent Angle Class II division 1 patients before functional orthopedic treatment.