中国实用口腔科杂志

中国实用口腔科杂志

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青少年单侧后牙正锁牙合畸形患者双侧髁突在关节窝内位置及其形态变化研究

魏子明a ，林丽佳a，李旼劼a，王雅蓉b   

  1. 南方医科大学口腔医院 a正畸科，b牙周种植科，广东  广州  510280
  • 出版日期:2019-07-15 发布日期:2019-08-28

  • Online:2019-07-15 Published:2019-08-28

摘要：

目的　观察并分析青少年单侧后牙正锁牙合畸形患者的双侧髁突在关节窝内位置及其形态变化。方法　选择2016年8月至2018年8月到南方医科大学口腔医院正畸科就诊的单侧后牙正锁牙合畸形患者35例为观察组，另选择同期就诊的后牙发育正常患者35例作为对照组，所有患者行锥形束CT（CBCT）扫描。分别比较两组患者的双侧关节间隙指标 ［包括关节前间隙（AS）、关节上间隙（SS）、关节后间隙（PS）］测量值及髁突形态指标（包括高度、内外径、前后径、体积、表面积）测量值，并对两组患者间的髁突形态不对称指数进行比较。结果　（1）对照组患者双侧关节间隙各指标（AS、SS、PS）测量值比较，差异均无统计学意义（P＞0.05）；观察组患者双侧关节间隙各指标测量值比较，AS锁牙合侧低于非锁牙合侧、PS锁牙合侧高于非锁牙合侧，差异均有统计学意义（P＜0.05），而SS两侧差异无统计学意义（P＞0.05）。（2）两组患者双侧髁突形态各指标（高度、内外径、前后径、体积、表面积）测量值比较，差异均无统计学意义（P＞0.05）。（3）观察组患者髁突高度不对称指数明显高于对照组，差异有统计学意义（P＜0.05），而内外径不对称指数、前后径不对称指数两组患者间比较，差异无统计学意义（P＞0.05）。结论　青少年单侧后牙正锁牙合畸形患者的双侧髁突在关节窝内位置发生改变，锁牙合侧与非锁牙合侧相比更靠前，但髁突形态基本对称，而CBCT能够为患者的锁牙合畸形诊断以及正畸方案提供可靠依据。

关键词: 锥形束CT, 正锁牙合, 髁突, 关节窝

Abstract:

Objective　To observe the position and morphological changes of bilateral condyles in the articular fossa in adolescent patients with unilateral scissors-bite posterior molar occlusion. Methods　Totally 35 patients with unilateral scissors-bite posterior molar，who visited Stomatology Hospital，Southern Medical university from Aug 2016 to Aug 2018，were randomly selected as observation group. Another 35 patients with normal development of posterior teeth who visited the hospital during the same period were randomly selected as control group. CBCT was performed in all patients. The values of AS，SS and PS in the bilateral joint space of the control group were compared，and the values of AS，SS and PS in the occlusal and non-occlusal sides of the occlusal sissors-bite of the observation group were compared. The height，internal and external diameters，anterior and posterior diameters，volume and surface area of the two condyles of the control group were compared，and the above indexes of occlusal and non-occlusal sides of the occlusal sissors -bite of the observation group were compared. The asymmetry index of condyle was compared between the two groups. Results　There was no significant difference in AS，SS or PS in the control group （P＞0.05）. In the observation group AS in the occlusal side was lower than that in the non-occlusal side，and PS in the occlusal side was higher than that in the non-occlusal side （P＜0.05），while there was no significant difference in SS （P＞0.05）. There was no significant difference in the height，internal and external diameter，anterior and posterior diameter，volume or surface area （P＞0.05）. The height asymmetry index in the observation group was significantly higher than that in the control group （P＜0.05），but there was no significant difference in the internal and external diameter asymmetry index or the anterior and posterior diameter asymmetry index between the two groups （P＞0.05）. Conclusion　The condylar position of the adolescent patients with scissors-bite malocclusion has changed，and the position of condyle in the joint fossa is more anterior than the normal side，but the shape of the condyle is basically symmetrical. CBCT can provide reliable evidence for the diagnosis of scissors-bite malocclusion and orthodontic program.

Key words: cone beam CT, CBCT；scissors-bite；condyle；articular fossa