安氏Ⅱ类1分类错(牙合)功能矫治前后患者髁突运动轨迹特征初探

目的：探讨功能矫治对安氏Ⅱ类1分类错[牙合]患者颞下颌关节功能的影响。方法：患者组（安氏Ⅱ类1分类错[牙合]）20例和对照组（安氏Ⅰ类）20人，记录患者组功能矫治前后及对照组开闭口运动时髁突运动状况，对结果进行秩和检验。结果：①相比对照组，患者组矫治前髁突轨迹明显垂直化，髁突垂直向位移[左侧为2．21（1．01）mm，右侧为1．12（1．02）mm]及倾斜度[左侧为12．89（9．12）°，右侧为12．12（8．89）°]偏大（P〈0．05）；②矫治后髁突轨迹在各个方向上的位移及倾斜度接近正常（P〉0．05）。结论：多数安氏Ⅱ类1分类错[牙合]患者的髁突运动轨迹有较稳定且可重复的特征；功能矫治对安氏Ⅱ类1分类错[牙合]患者的颞下颌关节功能调整有积极的作用。     

正畸治疗骨性Ⅲ类错(牙合)对下颌平面角小的成年女性患者颞下颌关节的影响

目的：分析正畸矫治前后成年女性骨性Ⅲ类错[牙合]低角患者颞下颌关节的变化，探讨非手术正畸治疗对成年骨性Ⅲ类错[牙合]低角患者颞下颌关节的影响。方法：选取16例成年女性骨性Ⅲ类错[牙合]低角患者，18～23岁，采用OPA-K滑动直丝弓技术矫治，矫治前后拍摄双侧闭口矫正许勒位片和头颅侧位X线片，进行颞下颌关节间隙测量和头影测量分析。对矫治前后的测量数据进行配对t检验。结果：与矫治前相比，矫治后关节前间隙线距和面积分别增加0．27mm（P〈0．001）、0．70mm^2（P〈0．01），关节后间隙线距和面积分别减小0．24mm、0.67mm^2（P〈0．001）,线性百分比由22．13％减少为9．64％（P〈0．001），关节后前间隙面积之比由1．56减小为1.19（P〈0.01），关节前间隙与关节后间隙趋于相等。头影测量发现，与矫治前相比，矫治后点Co、Ar、Go及Pg相对前颅底均明显后移（P〈0.05）。结论：成年骨性Ⅲ类错[牙合]低角患者非手术矫治后髁突由下前位向后向上移至中位，关节结构趋于协调和稳定，有利于颞下颌关节紊乱病症状的缓解。     

功能性矫治器治疗安氏Ⅱ1患者颞下颌关节MRI研究

目的:研究Herbst矫治器治疗安氏Ⅱ1错牙合后颞下颌关节的改建情况。方法:18例安氏Ⅱ1错牙合病例,治疗前后摄双侧颞下颌关节磁共振(MRI)片,在MRI片上测量髁状突表面软骨增生的量,并用Kurita法分析治疗前后髁状突、关节盘及关节窝之间位置关系的改变情况。结果:①髁状突后上方表面软骨有明显增生迹象:增生量最大1.3mm ,最小0 .6mm ,平均0 .93mm。②髁状突与关节窝,关节盘与关节窝位置关系治疗前后有显著性差异(P <0 .0 5 ) ,髁状突与关节盘位置关系治疗前后无显著性差异(P >0 .0 5 )。结论:Herbst矫治器可刺激髁状突、关节盘及关节窝产生适应性改建。     

伴有恒牙列早期安氏Ⅲ类错[牙合]的颞下颌关节音特征分析

目的安氏Ⅲ类错[牙合]对颞下颌关节（TMJ）的影响是正畸研究领域中的难点。本研究通过定量分析颞下颌关节音的特征,探讨恒牙列早期安氏Ⅲ类错[牙合]与TMJ之间的关系。方法选择安氏Ⅲ类错[牙合]受试者21名,并以个别正常[牙合]20例作对照。使用K6-Ⅰ型口颌系统功能检查仪中的电声谱仪（ESG electrosonogram）进行颞下颌关节音记录。结果比较安氏Ⅲ类及个别正常[牙合]两组测试者左（L）、右（R）两侧颞下颌关节关节音的峰频率（Peak frequeney,P）及强度（Amplitude,A）的均值,统计学上无差异,髁状突在开闭口的平滑运动过程中产生的声频为47Hz。结论颞下颌关节音的发生与恒牙列早期安氏Ⅲ类错[牙合]畸形间没有必然的联系;髁状突在开闭口时产生的声响可能是青少年颞下颌关节音的特征;电声谱仪可提供一个比较准确、无损伤的诊断手段。     

无症状青年颞下颌关节盘位置的MRI研究

目的 了解关节盘前移位在无症状青年志愿者中发生率,并探讨其颞下颌关节盘和髁突的位置关系。方法 根据D race标准确定无症状志愿者中关节盘前移位,并进行分组以及定点和相关数据的测量以确定盘-髁关系,对测得数据进行统计分析。结果 30名无症状志愿者中有7人(23.33%)存在单侧可复性关节盘前移位;髁突发育异常者2人(6.67%);双侧均正常者21人(70.00%)。关节盘-髁突位置的测定数据在各组间有统计学意义。结论 磁共振影像检查证实在无症状青年志愿者中存在关节盘前移位。     

安氏Ⅱ类错He关节窝,髁突,关节盘位置及关节盘形态变化的研究

目的 为探讨安氏Ⅱ＾１、Ⅱ＾２错Ｈｅ与颞下颌关节紊知病之间的关系。方法 利用矫正薛氏位Ｘ线片对Ⅱ＾１错Ｈｅ１６人,Ⅱ＾２错Ｈｅ１７人的双侧颞下颌关节的髁突居关节窝的位置进行评价,并依据髁突居关节窝中的位置（前移、居中、后移）,从上述两类错Ｈｅ中各选５人做双侧颞下颌关节矢状位核磁共振扫描,观察关节盘的位置及形态变化。结果 第一类型错Ｈｅ髁突居关节窝中的位置不一致;Ⅱ＾１错Ｈｅ髁突居关节窝中位,但轻度     

无症状志愿者颞下颌关节盘位置的磁共振观察

目的 通过磁共振成像了解无症状志愿者颞下颌关节关节盘位置的类型及其与年龄和性别的关系.方法 100名无症状志愿者分5组(11岁～、21岁～、31岁～、41岁～、51～60岁),每组男女各10名;利用Siemens Trio Tim 3.0 T磁共振扫描系统对双侧颞下颌关节进行开闭口斜矢状位扫描,共200侧关节;对每侧关节中间层及其相邻内、外各一层磁共振图像进行视觉诊断.结果 100名无症状志愿者中59名(59.0%)双侧关节盘位置正常.关节盘位置正常、关节盘前移位和隐匿性前移位的关节侧数分别为140侧(70.0%)、14侧(7.0%)和46侧(23.0%),在5个年龄组及不同性别之间的分布比较,差异均无统计学意义(P＞0.05).受试者最大开口度平均为(46.3±5.5)mm,不同关节盘位置的受试者间最大开门度比较,差异无统计学意义(P＞0.05).结论 在无症状志愿者中颢下颌关节盘移位确实存在,其分布与年龄和性别无关;盘移位以隐匿性前移位为主;关节盘移位的影像学表现与临床症状之间不存在确定的相关关系.     

安Ⅱ^1青少年颞下颌关节盘-突-窝位置关系的MRI研究

目的研究安Ⅱ1错合青少年颞下颌关节(TMJ)髁突在关节凹内的位置和盘突关系以及髁突位置和盘突关系之间的相关关系,探讨安Ⅱ1是否存在一定的TMJ病理结构.方法29例安Ⅱ1错合青少年(男14例,女15例),平均年龄10.8+1.1岁(8.1-13.0岁);摄取58侧TMJ的磁共振(MRI)片,测量分析突)窝、盘-突关系,与正常值相比较,并对髁突位置与盘突关系进行相关分析.结果反映髁突位置的JSI,Ca-Ti值与正常值之间有显著差异(P＜0.05),显示髁突处于前移位;反映盘突关系的各测量值稍比正常值前位,但差异无显著性;髁突位置与盘突关系相关系数多在0.013～0.213之间;盘前移位组与盘正常组的髁突位置差异无显著性.结论安Ⅱ1错合青少年髁突位置呈前移位,关节盘相对髁突偏前位但在正常生理范围内;未发现髁突位置与盘突关系之间存在相关关系.     

术前正畸对颞下颌关节关节盘及髁突位置和形态的影响

目的 探讨术前正畸对颞下颌关节关节盘及髁突位置和形态的影响。方法 选择骨性错畸形患者30例,在颞下颌关节磁共振图像上进行测量。通过关节间隙测量,判定髁突位置;通过髁突头长度、宽度和高度测量,判定髁突形态;关节盘位置和形态由直接观察判定,采用SPSS 24.0软件包对所得数据进行统计学分析,比较骨性Ⅰ、Ⅱ和Ⅲ类畸形患者在术前正畸前、后关节盘及髁突位置和形态变化。结果 术前正畸前、后关节间隙和关节间隙指数,髁突头长度、宽度和高度、关节盘前移角及关节盘形态差异均无统计学意义（P>0.05）。结论 术前正畸治疗不会导致骨性错畸形患者关节盘及髁突位置和形态改变。     

Magnetic resonance imaging of the temporomandibular joint

Correct diagnosis of internal derangements of the temporomandibular joint requires both a comprehensive clinical and radiographic evaluation. Plain film tomography, transcranial radiography, arthrography and computed tomography have all been used to assess the status of the joint structures. Magnetic resonance imaging is a relatively new modality used for imaging many different organ systems. Magnetic resonance imaging of the temporomandibular joint has certain distinct advantages over previously used techniques in evaluating patients for internal joint derangements. The applicability of magnetic resonance imaging in the diagnosis of internal derangements will be discussed.     

Magnetic resonance imaging of the temporomandibular joint meniscus

This report describes early experience with magnetic resonance imaging (MRI) of the temporomandibular joint meniscus in which surface coil technology was used. The results suggest remarkable imaging capabilities and speed with noninvasive methods.     

Magnetic resonance imaging predictors of temporomandibular joint pain

BACKGROUND: The authors conducted a study to evaluate whether temporomandibular joint, or TMJ, disorder subgroups are related to magnetic resonance imaging, or MRI, diagnoses of TMJ internal derangement, or ID; osteoarthrosis, or OA; effusion; and bone marrow edema. METHODS: The TMJ disorder group was composed of 118 subjects with TMJ pain who were assigned a clinical unilateral single diagnosis of a specific TMJ disorder. The control group consisted of 46 subjects who did not have TMJ pain. Sagittal and coronal magnetic resonance images were obtained to establish the prevalence of ID, OA, effusion and bone marrow edema. The authors used a multiple logistic regression analysis to compute the odds ratios, or OR, for MRI features for control subjects versus four groups of subjects who had TMJ pain: ID type I (n = 35), ID type III (n = 39), capsulitis/synovitis (n = 26) and degenerative joint disease, or DJD, (n = 18). RESULTS: MRI diagnoses that did not contribute to the risk of TMJ pain included disk displacement, or DD, with reduction and effusion. Significant increases in the risk of experiencing TMJ pain occurred selectively with DD without reduction (OR = 10.2:1; P = .007) and bone marrow edema (OR = 15.6:1, P = .003) for the ID type III group and with DD without reduction (OR = 11.7:1, P = .054) for the DJD group. Subjects in the group with ID type I were less likely to be associated with an MRI finding of OA than were control subjects (OR = 1:5.6). CONCLUSIONS: While the contribution of MRI variables to the TMJ pain subgroups was not zero, most of the variation in each TMJ pain population was not explained by MRI parameters. Thus, MRI diagnoses may not be considered the unique or dominant factor in defining TMJ disorder populations. CLINICAL IMPLICATIONS: Therapy for subjects with TMJ based on the evaluation of concomitant morphological abnormalities, whether prophylactically or as treatment for TMJ disorders, may be unwarranted.     

Magnetic resonance imaging of partial temporomandibular joint disc displacement

Unilateral magnetic resonance imaging (MRI) of the symptomatic temporomandibular joint (TMJ) was performed on 55 patients. The position of the articular disc in relation to the condyle was established on sagittal images. Particular attention was paid to partial or complete anterior positioning of the disc. MRI was correlated with clinical and, in 33 cases, surgical findings. The concept of partial anterior displacement may be useful in relation to treatment planning.     

Magnetic resonance imaging assessment of temporomandibular joint soft tissue injuries of intracapsular condylar fracture

We evaluated the soft tissue of the temporomandibular joint (TMJ) with magnetic resonance imaging (MRI) after intracapsular condylar fracture. Eighteen consecutive patients (19 TMJ) were diagnosed between 1 January 2010 and 30 October 2011. They were examined using bilateral sagittal and coronal MRI, which were obtained immediately after injury to assess the displacement of the disc, whether there was a tear in capsule or the retrodiscal tissue, and whether there was an effusion in the joint. On the affected side MRI showed disc displacement in 15 of 19, tears in the capsule in 9, and tears in the retrodiscal tissue in 16. All 19 had joint effusions. It also showed 2 joints with abnormalities on the unaffected side. We conclude that MRI is useful for diagnosis and for estimating the amount of damage to the TMJ, and is helpful in planning treatment.