共查询到18条相似文献,搜索用时 62 毫秒
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目的 分析下颌髁突脱位骨折后颞下颌关节(TMJ)软组织改变的MRI表现.方法 应用矢状面和冠状面质子密度加权成像(PDWI)和T2WI连续检查103侧(77例)患有下颌髁突脱位骨折的颞下颌关节(TMJ).结果 MRI上,103侧髁突脱位骨折后的TMJ异常表现有:(1)髁突骨折断片向前下(102侧,99.0%)和前(1侧,10%)脱位;(2)关节盘移位(100侧,97.1%),其中矢状面MRI显示关节盘随脱位的髁突向前下移位者99侧,向前移位者1侧;(3)关节腔积液(103侧,100%);(4)关节盘后区信号异常(91侧,88.3%);(5)关节盘下后附着异常(89侧,86.4%);(6)关节囊异常(89侧,86.4%);(7)关节盘上后附着异常(37侧,35.9%);(8)关节盘变形(8侧,7.8%);(9)关节盘撕裂(8侧,7.8%);(10)颞骨关节窝骨折(4侧,3.9%).结论矢状面MRI上,多数下颌髁突脱位骨折以TMJ关节盘随脱位的髁突向前下移位,并伴有关节腔积液为特点. 相似文献
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颢下颌关节强直术后复发问题目前尚未解决,虽然通过不断改进术式和放置各种填隔物,使复发率明显降低,但迄今仍在17.5%左右。本文结合15例颞下颌关节强直复发再次手术所见,对复发因素进行分析。 1 临床资料本组15例,男10例,女5例;年龄12~42岁。 相似文献
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目的:观察髁状突纵形骨折后及He夹板治疗时双侧颞下颌关节区的血流情况。探讨He夹板治疗机制。材料和方法:中国实验用小型猪14头,分为髁状突纵形骨折未治疗组、He夹板治疗组及正常对照组。分别于髁状窦纵形骨折后2、3、4、12周做核素三相骨扫描检查。结果 髁状穿纵形骨折侧颞下颌关节(Temporomandibular jount,TMJ)血流相的时间-放射性强度曲线改变大,峰值升高,峰时后延,以2周时 相似文献
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目的 探讨保留髁突和颞下颌关节盘的术式对于治疗创伤性颞下颌关节内强直Ⅲ型的疗效.方法 创伤性颞下颌关节内强直Ⅲ型8例,男4例,女4例;年龄7~22岁,平均13.6岁.病程1~12年,开口度2~10 mm.手术方法为去除外侧髁突骨折断面形成的骨痂,将髁突磨改成形,在内侧寻找分离出移位的关节盘,松解后将关节盘的外侧端缝合固定至外侧关节囊或软组织.结果 术后随访6~38个月,患者开口度平均30 mm,无关节疼痛及弹响症状,随访期内无复发.结论 采用保留髁突和关节盘的方法治疗创伤性颞下颌关节内强直Ⅲ型,方法简单易行,创伤小,能有效防止复发. 相似文献
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生长因子是一组具有促进细胞生长、增殖和合成作用的蛋白多肽。软骨组织中含有多种生长因子及其受体,它们共同作用于软骨细胞。颞下颌关节髁突软骨属于纤维软骨,它介导了髁突的生长发育及适应性改建。髁突软骨细胞同样受到多种生长因子的调控,主要有:胰岛素样生长因子(insulin-like growth factor,IGF)、转化生长因子-β(transforming growth factor-β,TGF—β)、 相似文献
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目的:探讨牵张成骨技术在颞下颌关节强直伴小下颌畸形治疗中的应用效果。方法:对6例颞下颌关节强直伴严重小下颌畸形的患者采用一期下颌骨双向牵张成骨、二期颞下颌关节成形术进行治疗。结果:所有患者术后均顺利完成牵引计划,并在3个月后拆除牵张器,面容获得极大改善,张口度达到25mm以上,睡眠呼吸暂停症状消失,营养状况改善,口内咬合关系基本恢复。结论:牵张成骨技术为临床上治疗颞下颌关节强直伴严重小下颌畸形提供了有效方法。 相似文献
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目的 探讨99Tcm-MDP SPECT颞颌关节显像对髁突肥大的诊断价值.方法 回顾性分析2009年至2010年行99Tcm-MDP SPECT颞颌关节显像的髁突肥大(临床确诊)患者56例(男22例,女34例,平均年龄21.5岁),其中31例接受了髁突高位切除术并有组织病理学结果.另收集10例因恶性肿瘤等其他疾病行骨显像的对照者,男女各5例,平均年龄22.6岁,加做颞颌关节显像.对所有研究对象进行SPECT图像分析及半定量分析,采用独立样本t检验比较髁突肥大组与对照组间患侧髁突/顶骨及患侧髁突/双侧髁突的摄取比差异,髁突肥大组患侧与健侧的摄取差异行配对t检验.对手术治疗患者的SPECT结果与其病理结果进行Pearson相关分析.结果 髁突肥大组患侧髁突/顶骨摄取比(1.66 ±0.63)及患侧髁突/双侧髁突摄取比(0.59±0.44)均明显高于对侧(1.34±0.34、0.41±0.04,t=3.687和6.590,均P<0.01),并且明显高于对照组左侧髁突相应数据(1.12 ±0.07和0.50±0.01,t =6.459和4.750,均P<0.001).SPECT检查诊断髁突生长活跃的灵敏度为95.2%(20/21),特异性为60.0%(6/10),阳性预测值为83.3% (20/24),阴性预测值为6/7.患侧髁突/双侧髁突摄取比与软骨组织增生的厚度无明显相关[软骨膜、增殖层、肥大层的平均厚度分别为(150.5±94.9)、(185.2±113.6)、(167.7 ±76.9)μm,r=0.46、0.47、-0.12,均P>0.05].结论 99Tcm-MDP SPECT颞颌关节显像能够有效评估髁突肥大患者的骨质生长活性,为手术方式的选择提供重要依据. 相似文献
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Temporomandibular joint (TMJ) ankylosis is characterized by the formation of bony or fibrous mass, which replaces the normal articulation and limitation of mouth opening. This study aims to determine the efficacy of arthroplasty and interpositional fascia flap in the treatment of unilateral and bilateral TMJ ankylosis in three young adult men. Our operative protocol for unilateral and bilateral TMJ ankylosis entailed resection of ankylotic mass, intraoral ipsilateral and bilateral arthroplasty, interpositional tissue transfer to the TMJ with temporalis superficial fascia flap, maxillomandibular fixation, and early mobilization and aggressive physiotherapy. Early postoperative initial exercise, physiotherapy, and strict follow-up play an important role in preventing postoperative adhesions. The temporalis superficial facia flap is an autogenous graft that has the advantages of close proximity to the TMJ minimal surgical morbidity, and successful clinical results. It was found to be a valuable option for TMJ ankylosis reconstruction. 相似文献
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OBJECTIVES: To compare the pre-operative clinical and radiographic findings of temporomandibular joint (TMJ) ankylosis with those found at operation and propose new classification. METHODS: Thirty-three patients were treated for TMJ ankylosis. There were 18 unilateral and 12 bilateral cases. All patients underwent pre-operative clinical and radiographic examination, (consisting of a panoramic radiograph, axial and coronal CT. The surgical findings were compared with the imaging features. RESULTS: Post-contrast coronal CT was the best imaging modality for planning surgery as it displayed the anatomical relationship between the ankylosed segment and the surrounding vital structures, particularly where the sphenoid and temporal bones were involved. CONCLUSIONS: Surgical planning should be based on coronal and axial CT. A new classification of TMJ ankylosis based on the CT findings is proposed. 相似文献
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J Schilling L C R Gomes E Benavides T Nguyen B Paniagua M Styner V Boen J R Gon?alves L H S Cevidanes 《Dento maxillo facial radiology》2014,43(1)
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To investigate the reliability of regional three-dimensional registration and superimposition methods for assessment of temporomandibular joint condylar morphology across subjects and longitudinally.Methods:
The sample consisted of cone beam CT scans of 36 patients. The across-subject comparisons included 12 controls, mean age 41.3 ± 12.0 years, and 12 patients with temporomandibular joint osteoarthritis, mean age 41.3 ± 14.7 years. The individual longitudinal assessments included 12 patients with temporomandibular joint osteoarthritis, mean age 37.8 ± 16.7 years, followed up at pre-operative jaw surgery, immediately after and one-year post-operative. Surface models of all condyles were constructed from the cone beam CT scans. Two previously calibrated observers independently performed all registration methods. A landmark-based approach was used for the registration of across-subject condylar models, and temporomandibular joint osteoarthritis vs control group differences were computed with shape analysis. A voxel-based approach was used for registration of longitudinal scans calculated x, y, z degrees of freedom for translation and rotation. Two-way random intraclass correlation coefficients tested the interobserver reliability.Results:
Statistically significant differences between the control group and the osteoarthritis group were consistently located on the lateral and medial poles for both observers. The interobserver differences were ≤0.2 mm. For individual longitudinal comparisons, the mean interobserver differences were ≤0.6 mm in translation errors and 1.2° in rotation errors, with excellent reliability (intraclass correlation coefficient >0.75).Conclusions:
Condylar registration for across-subjects and longitudinal assessments is reliable and can be used to quantify subtle bony differences in the three-dimensional condylar morphology. 相似文献15.
OBJECTIVES: The purpose of this study was to examine changes in condylar mobility and morphological changes in the affected condyles after treatment in patients with non-reducing disc displacement of the temporomandibular joint (TMJ). METHODS: Changes in condylar mobility and morphological changes of the condyle were examined radiographically in 55 patients who were diagnosed as having non-reducing disc displacement of the unilateral TMJ and had received pumping with injection of sodium hyaluronate. In all patients, standardized lateral oblique transcranial radiographs and panoramic jaw tomograms were taken both at initial visit and at 12 months or more follow-up (mean 28.1 months after treatment; range 12-104 months). 42 joints in 21 persons with no current or previous TMJ symptoms served as a control. RESULTS: Clinical signs and symptoms improved after treatment in the patients. Condylar mobility significantly increased after treatment in patients (P<0.001), although it did not reach levels of the control group. Frequency of radiographic changes of the condyle significantly increased after treatment (P<0.005). In most of the patients, no or only mild changes were observed. Frequency of changes of the condyle in patients at follow-up was significantly greater than that in controls (P<0.001). CONCLUSIONS: In the patients, condylar mobility increased in the subsequent course after treatment. However, bony changes of the condyle appeared more frequently. Long term-follow-up after treatment on bony changes of the condyle seems to be necessary in patients with non-reducing disc displacement of the TMJ. 相似文献
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目的 探讨基质金属蛋白酶-3(matrix metalloproteinase-3,MMP-3)在羊颞下颌关节((temporomandibular joint,TMJ))间接创伤后骨关节病发生中的作用。方法 用自制撞击装置造成山羊双侧颞下颌关节间接性创伤,分别于伤后1周、1,3,6个月取TMJ髁突软骨,并以正常TMJ作为对照,用免疫荧光组织化学方法观察MMP-3的表达。结果 TMJ髁突软骨中MMP-3伤后1个月表达开始增强,后期进一步增强;荧光着色于软骨破坏区及增生的滑膜样组织、软骨肥大带及骨髓内较强,正常对照组基本呈阴性反应。结论 MMP-3参与了TMJ创伤所致TMJ骨关节病过程,并起了重要作用。 相似文献
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Bifid mandibular condyle with ankylosis is an extremely rare condition and may arise as a developmental or traumatic defect. We report here a case of bilateral bifid mandibular condyle with ankylosis in a 6-year-old child. The patient had severe limitation of mouth opening and history of trauma 2 years ago. 相似文献
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J S Zheng Z X Jiao S Y Zhang C Yang A Abdelrehem M J Chen D M He M J Dong 《Dento maxillo facial radiology》2015,44(4)