上颌复合体与颅部位置关系的头影测量研究——角度与线距的相关关系及补偿机制

目的 :本研究通过X线头影测量阐述上颌复合体与颅部位置关系中角度与线距的相关关系和补偿机制。方法 :采用 92例侧貌正常的恒牙列者的X线头影测量图进行测量分析。结果 :在影响面中部突度的各项角度、线距之间及其内部均存在明显的相关关系和较为密切的补偿关系。结论 :上颌复合体与颅部位置关系中的相关关系及补偿机制保证了颅面结构及侧貌的美观、协调、平衡。对口腔正畸医生而言 ,要对临床病例进行综合、全面的分析。     

不同骨面型患者蝶鞍尺寸的测量分析

目的:测量不同骨面型患者蝶鞍尺寸并探讨其与颅面部各测量项目之间的相关性。方法:对126例错牙合畸形患者的头颅侧位片进行回顾性研究,按矢状骨面型分为骨性Ⅰ类组、骨性Ⅱ类组、骨性Ⅲ类组;按垂直骨面型分为均角组、低角组、高角组。测量颅面部相关硬组织数据以及蝶鞍尺寸,并进行统计学分析。结果:(1)不同性别患者蝶鞍尺寸无显著差异(P>0.05);(2)矢状骨面型组中,各组患者的蝶鞍尺寸无显著差异(P>0.05);(3)垂直骨面型组中,高角组蝶鞍直径、深度、面积最大(P<0.05),均角组与低角组的蝶鞍尺寸无显著差异(P>0.05);(4)蝶鞍长度与下颌平面角呈正相关(P<0.05);直径、深度、面积均与全面高、下面高、下颌体长、下颌平面角呈正相关(P<0.05)。结论:蝶鞍尺寸与垂直骨面型存在相关性,即蝶鞍直径、深度、面积越大,高角型趋势就越明显,可为正畸诊疗提供参考。     

术前正畸对骨性Ⅲ类畸形患者颞下颌关节关节盘和髁突位置影响的MRI研究

目的 探讨术前正畸对骨性Ⅲ类畸形患者颞下颌关节关节盘和髁突位置的影响.方法 选择骨性Ⅲ类畸形患者20例,通过影像科医生的诊断判定关节盘移位类型,通过对颞下颌关节磁共振图像进行关节间隙测量判定髁突位置情况,观察术前正畸治疗前后关节盘和髁突的位置变化.结果 术前正畸治疗不会导致关节盘的位置变化(P＞0.05).术前正畸前后...     

正畸治疗前、中、后的面部生长

本文对一些病人在正畸治疗前、治疗时和治疗后的面部生长方面进行有比较的纵向研究,借以确定正畸治疗能否改变面部生长方向。作者对19名正畸病人作系列X线头影测量,描记蝶鞍、前颅底、上下颌、眶部和耳点的位置,描记眼耳平面用以比较生长方向,测出鼻前棘和颏点移动同限耳平面的关系,以便作矫治前、中、后的比较。矫治以方形弓线完成,辅助器包括各式口外牵引和颌间     

下颌后退术后舌骨、舌体位置和咽腔间隙变化的锥形束CT分析

目的研究正畸-正颌联合治疗骨性Ⅲ类错畸形对舌骨、舌体位置和咽腔间隙的影响,分析下颌后退与舌骨、舌体位置改变和咽腔间隙缩窄之间的相关性。方法选取经正畸-正颌联合治疗的患者20例为研究对象,于正颌手术前1周及术后6个月拍摄锥形束CT,三维重建颅颌面、气道及舌骨的立体模型,建立以蝶鞍中心（S）点为原点的三维坐标系。测量治疗前后咽腔各段最窄处的矢状径、冠状径、截面积,各段容积和咽腔总容积,同时测量颏前点、舌骨点、舌根点的三维位置,分析颏前点的变化与咽腔间隙及舌骨、舌体位置变化的相关性。结果治疗后,咽腔间隙呈现整体缩窄趋势。舌骨发生了后下移位,其中向后、向下平均移动距离分别为5.72、2.76 mm（P<0.05）;舌根点向后平均移动了4.04 mm（P<0.01）。19项相关性比较中,有统计学意义的项目有14项,其中下颌后退量与咽腔总容积改变的相关性最强（r=0.834,P<0.01）。结论正畸-正颌联合治疗骨性Ⅲ类错畸形可造成咽腔缩窄,舌骨后下移位,舌体向后移位;下颌后退量与咽腔间隙缩窄、舌骨和舌体位置的改变具有较强的相关性。     

下颌口外颏兜矫正器的矫形作用

有关下颌的生长及组织学的变化已有不少论著,但在使用矫形及正畸的矫正器时,对下颌形态结构的变化及颅面结构的作用的论述则甚少。作者利用弹性照相材料、技术,对使用口外颏兜的下颌施以矫形力时,在方向、大小、位置三相进行研究。文献复习: 矫形力的使用并非是最近的新概念。     

用下颌角前切迹深度来预测下颌生长潜力

本研究通过纵向头颅侧位片比较下颌角前切迹深组和浅组病人的颅面特征和下颌生长潜力,目的在于回答以下问题: 1.下颌角前切迹的深度是杏与特定的颅面形态有关?2.下颌角前切迹的深度是否可用来预测下颌的生长方向和/或生长潜力? 本研究的样本来源于正畸固位后的病案,按治疗前头测位片下颌角前切迹的深度分别选25例组成角前切迹深组和浅组。角前切迹深度的测量方法为:在头侧位片上连接下颌角下缘     

口腔诊断学

螺旋CT三维重建用于正畸埋伏牙定位的临床研究;数字化牙片图像质量的临床分析;下颌前突患者下颌支厚度的CT测量;利用曲面断层片进行下颌骨测量的研究;颅锁骨发育不全综合征的X线特征分析;颞下颌开口指数在颞下颌关节紊乱病中的诊断价值     

50例外科矫正下颌前突病例的头测量分析

作者对50例外科矫正下颌前突的成人病例进行了分析研究。于术前、术后及去除夹板后至少一年,即硬组织位置较为稳定时,分别摄照X线头颅侧位像,测量代表上下颌位置及其对颅底关系的SNA角(蝶鞍中心—鼻根点—上齿槽座点角),SNB角(蝶鞍中心—鼻根点—下齿槽座点角),ANB角(上     

正畸治疗中利用锥形束CT测量牙根位置方法的研究进展

牙根位置对于正畸治疗的健康、稳定、美观具有重要意义。过去应用二维放射影像评估牙根位置的准确性、精度不佳。近年来,利用锥形束CT(cone beam CT,CBCT)及其重建影像测量牙根三维空间位置及角度已经成为主流。牙根位置主要通过在颊舌向、垂直向、近远中向三个方向上测量牙根与邻近结构的关系及测量牙根角度来描述。牙根颊舌侧的牙槽骨厚度代表颊舌向位置,牙根在牙槽骨中的垂直高度及与上颌窦的距离关系代表垂直向位置,根间牙槽骨厚度代表牙根近远中向位置,牙根角度则多以传统的二维测量中的下颌中切牙-下颌平面角、轴倾角、转矩等角度表示。拟合CBCT和数字化模型数据能监测正畸治疗中的牙根与牙槽骨位置关系,但需要更为全面、规范的牙根位置三维测量方法,以充分利用CBCT提供的牙根数据研究相对于不同层次解剖结构的牙根最佳位置,从而与计算机技术结合优化正畸诊疗数字化设计。     

Morphology of the sella turcica in Axenfeld–Rieger syndrome with PITX2 mutation

Background:  Axenfeld–Rieger syndrome (ARS) is a rare autosomal dominant disorder with an incidence of 1:200 000. Genotype and phenotype are heterogeneous and clinical morphology impresses with variable expressivity. Additionally to the typical craniofacial and dental aberrations anomalies in the morphology of sella turcica are discussed.
Method:  In a multidisciplinary genetic and clinical study four patients of a family with ARS were screened by direct DNA sequencing. Radiographic analysis of the patients was performed for evaluating cranial and dental structures. Additionally, a specific analysis of the morphology of the sella turcica was made on the radiographs.
Results:  Screening for PITX2 and FOXC1 mutations revealed a P64L missense mutation in PITX2 in all four patients. The cephalometric analysis showed a midface hypoplasia associated with a skeletal Class III. All patients showed a sella turcica bridge combined with a prominent posterior clinoid process followed by a steep clivus and an elongated sella turcica.
Conclusion:  The incidence of a sella turcica bridge in combination with a PITX2 mutation would suspect that sella turcica anomalies are typical symptoms of the syndrome. Sella turcica anomalies in association with craniofacial and dental aberrations, such as maxillary retrognathia, skeletal Class III relationship and hypoplasia of teeth, might be important indicators for ARS caused by PITX2 mutation.     

Sella turcica morphology in patients with genetic syndromes: A systematic review

The sella turcica is an important anatomical reference used in orthodontics for the evaluation of craniofacial growth. Studies have found variations in the sella turcica morphology in patients with syndromes affecting the craniofacial complex. This review aims to determine whether genetic syndromes involving the craniofacial complex are associated with abnormal radiographic sella turcica morphology and whether there is a pattern of malformation which is consistent within each syndrome. An electronic database search was conducted to identify relevant studies. We included primary studies describing the morphology of the sella turcica on lateral radiographs in human subjects with genetic syndromes involving the craniofacial complex. No restrictions were placed on language or timeframe. PROSPERO registration CRD42019148060. Thirty-eight studies were included in this review. A ‘J’-shaped sella was found in patients with Hutchinson-Gilford-Progeria syndrome and other syndromes. A bulbous dorsum sellae was highly prevalent Cleidocranial dysplasia, and a bulbous dorsum sellae and uneven contours of the clivus was found in Cri du chat syndrome. A steep clivus was described in patients with Axenfeld-Rieger syndrome. An oblique anterior wall was the most frequent malformation found in Down’s syndrome. Genetic syndromes affecting the craniofacial complex are associated with abnormal morphology of the radiographic sella turcica. Clinicians should be observant of abnormal sella turcica morphology which can be a sign of undiagnosed or subclinical syndromes. More high-quality studies are needed which use standardized and objective methods of determining the morphology of the sella turcica.     

上颌侧切牙先天性缺失与蝶鞍相关性研究

目的 比较上颌侧切牙先天性缺失患者和牙列完整患者的蝶鞍大小,评估鞍桥和上颌侧切牙先天性缺失之间是否存在联系.方法 以上颌侧切牙先天性缺失患者作为试验组,牙列完整者作为对照组,每组各80例.利用Dolphin软件测量蝶鞍的大小,记录蝶鞍鞍桥的钙化程度.结果 两组间的蝶鞍大小除长度以外差异均无统计学意义.试验组与对照组在鞍...     

A sella turcica bridge in subjects with severe craniofacial deviations

In earlier studies, a sella turcica bridge was stated to occur in 1.75 to 6 per cent of the population. The occurrence of a sella turcica bridge has not previously been studied in a group of patients with craniofacial deviations treated by surgery. Profile radiographs from 177 individuals who had undergone combined orthodontic and surgical treatment at the Copenhagen School of Dentistry were studied. A sella turcica bridge was registered in those subjects where the radiograph revealed a continuous band of bony tissue from the anterior cranial fossa to the posterior cranial fossa across the sella turcica. Two types of sella turcica bridge were identified. A sella turcica bridge occurred in 18.6 per cent of the subjects.     

The morphology of sella turcica in cleft and non-cleft individuals

Aims and ObjectivesThe aim of the study was to analyze the morphology and expedient the linear dimensions of Sella Turcica among cleft and non-cleft Indian individuals, and then to determine whether differences exist between different study groups.Materials and methodsThe lateral cephalogram of 300 patients (150 cleft and 150 non-cleft), aged 18 to 30 years who reported for various treatments of malocclusions were studied.ResultThe normal morphology of the sella turcica were seen in 85 of the 150 non-cleft individuals which was highest (56.66%) in the non-cleft group, however in the cleft group it was seen in only 16 of the 150 individuals (10.6%). Sella turcica bridge were seen in 10% of the non-cleft subjects, whereas in the cleft group it was seen in 38% of the individuals. A significant difference was seen in the linear measurements of the sella turcica of cleft and no-cleft individuals.ConclusionThe normal morphology of the sella turcica was seen in the majority of the non-cleft individuals. The cleft individuals showed an increased incidence of sella turcica bridging with reduced linear measurements of the sella as compared to the non-cleft individuals.     

不同类型骨性错畸形患者蝶鞍特征研究

目的探讨不同类型骨性错畸形患者的蝶鞍大小、形态和鞍桥发生率。方法选取2016年7月至2019年9月于中国医科大学附属口腔医院第一门诊及正畸二科就诊的骨性Ⅰ类错畸形患者100例(Ⅰ组)、骨性Ⅱ类错畸形患者100例(Ⅱ组)、骨性Ⅲ类错畸形患者100例(Ⅲ组)。收集各组患者头颅侧位片,使用Winceph8.0软件定位相关标记点,并测量蝶鞍的长度、深度和直径,同时记录蝶鞍的形态(扁平形、椭圆形、圆形)以及鞍桥的类型(无鞍桥、部分鞍桥、完全鞍桥),计算各组患者鞍桥发生率。应用SPSS 25.0软件对数据进行统计学分析。结果各组患者蝶鞍大小、形态比较,差异均无统计学意义(均P> 0.05);但其鞍桥发生率比较,差异有统计学意义(P <0.001),其中Ⅲ组患者鞍桥发生率(66.0%)明显高于Ⅰ组(17.0%)和Ⅱ组(34.0%)。不同性别患者蝶鞍大小、形态及鞍桥发生率比较,差异均无统计学意义(均P> 0.05)。结论骨性Ⅲ类错畸形患者的鞍桥发生率显著增加,提示鞍桥的发生可能与颅颌面发育异常相关。     

恒牙先天缺失患者蝶鞍和颅底的头影测量研究

目的 探究不同程度恒牙先天缺失患者蝶鞍与颅底的大小及形态差异。 方法 选取2020—2021年就诊于四川大学华西口腔医院正畸科的322例患者为研究对象,依据先天缺牙数目将患者分为3组：对照组（无恒牙先天缺失,112例）;试验Ⅰ组（先天缺失1~2颗恒牙,104例）;试验Ⅱ组（先天缺失3颗及以上恒牙,106例）。使用Uceph头影测量软件对每位患者头颅侧位片的蝶鞍的长度、深度和直径以及颅底相关线性和角度参数进行测量。对每位患者的蝶鞍形态进行判定。采用SPSS 21.0软件对数据进行统计学分析。 结果 3组的蝶鞍长度、深度、直径以及颅底相关的线性和角度参数差异均无统计学意义（P>0.05）。3组的鞍桥发生率的差异有统计学意义（P=0.013）,试验组高于对照组（P<0.05）,试验Ⅰ组和试验Ⅱ组差异无统计学意义（P>0.05）。 结论 虽然蝶鞍的线性大小及颅底特征在正常人和先天缺牙患者中未见明显差异,但在先天缺牙患者中鞍桥发生率更高,提示该人群的蝶鞍解剖学形态可能异常。     

Post-natal size and morphology of the sella turcica in Williams syndrome

Williams syndrome (WS) is a rare congenital disorder with distinctive craniofacial features, cardiovascular abnormalities, mental retardation, and behaviour characteristics.The purpose of this study was to investigate the size and morphology of the sella turcica on profile cephalograms in a group of individuals with WS. The material consisted of radiographic cephalograms of 62 Norwegian children, adolescents, and adults with an age range of 4.7-44.4 years. The length, depth, and diameter of the sella turcica were measured and the mean values were compared with normal reference material from the Oslo University Craniofacial Growth Archive. In total, the two-dimensional size of the sella turcica in the WS group was smaller in length, depth, and diameter compared with the control group, but only occasionally reached a significance level of 5 per cent (Student's t-test).The morphology of the sella turcica was assessed and five different morphological types were identified; oblique anterior wall, extremely low sella turcica, sella turcica bridging, irregularity (notching) in the posterior part of the dorsum sellae, and pyramidal shape of the dorsum sellae. The occurrence of these morphological types was more frequent in the WS subjects compared with the reference material, except for sella turcica bridging, which was equally frequent. The females with WS had more dysmorphic sella turcicas than males.This study has demonstrated morphological aberrations in the sella turcica in Norwegian individuals with WS, which should be further elucidated in future research and combined with neurological andendocrinological investigations.     

A cephalometric morphometric study of the sella turcica

The purpose of this study was to use quantitative methods to measure the size and shape of the sella turcica and thus establish normative reference standards that could assist in a more objective evaluation and detection of pathological conditions. Standardized lateral cephalograms of 184 healthy Greeks (91 males and 93 females) were used. The age range was between 6 and 17 years. Conventional measurements included three different heights of the sella turcica (anterior, posterior, median), its length, and width, measured in relation to the Frankfort reference line. In addition, the area of sella turcica was calculated. Morphometric methods were used to assess shape. The tracings were superimposed using the Procrustes method, and the average shape was computed. Principal component analysis (PCA) was used to assess shape variability. The data were correlated with centroid size, age, and gender. Unpaired t-tests were used to determine gender differences. Sella height anteriorly was the only variable found to be significantly different between the genders, being larger in females by 0.5 mm. Linear and area measurements were found to be significantly correlated with age, but all correlations were low (r(2) below 8 per cent). Sella turcica shape, as described by PCA, was different between males and females, mainly at the posterior aspect of the sella outline. However, although there was an extensive overlap between the genders, and differences were minimal. Age was not found to be correlated with the shape coefficients, although, in the female group, the first principal component of shape was marginally not significant. Allometry was observed in both genders, the sella showing a tendency towards a flatter and wider shape with increase in size. The results of this study constitute quantitative reference data that could be used for objective evaluation of sella shape.     

中国东北地区3～24岁正畸患者的蝶鞍形态

目的观察中国东北地区3~24岁正畸患者的蝶鞍形态,分析不同年龄段的生长变化,为临床诊断及应用提供参考依据。方法选择2008—2015年就诊于中国医科大学附属口腔医院正畸科的患者1 758例,测量每位患者的头颅侧位定位片,分别得出男性和女性蝶鞍的长度、深度、最大直径,观察蝶鞍形态伴随生长发育的变化情况。使用SPSS17.0统计软件对所得数据进行统计学分析。结果在生长发育过程中,蝶鞍的长度、深度、最大直径随着年龄的增加逐渐增大,18岁以后蝶鞍形态趋于稳定。蝶鞍的长度、深度变化均匀而缓慢,蝶鞍的最大直径的变化存在高峰期,即男性12~16岁,女性10~14岁。结论蝶鞍大小随年龄增长而逐渐增大,蝶鞍的最大直径的变化存在高峰期。