利用CBCT分析颞下颌关节骨关节病髁突松质骨结构的变化特征

发布时间：2018-05-09 16:04

  本文选题：锥形束CT + 颞下颌关节　； 参考：《大连医科大学》2017年硕士论文

【摘要】：目的:探讨研究不同年龄层颞下颌关节骨关节病髁突松质骨结构变化特征。方法:选取2007年至2010年期间在北京大学口腔医院颞下颌关节门诊就诊,并确诊单侧患病的颞下颌关节骨关节病的患者共142名(年龄18～82岁),按年龄将其分为5组:18～29岁,30～39岁,40～49岁,50～59岁及60岁以上,所有患者的双侧髁突均经过锥形束CT扫描并且选择最典型的健康侧和骨关节病患病侧冠状位图像,共获取284幅图像,骨关节病侧和正常对照侧各142幅图像。判读患者CBCT图像,判断其病变阶段和病变程度。经图像重建后将健康侧和患病侧图像导入自行研究开发的图像处理软件中进行处理,分析患病侧与健康侧的骨体积分数、骨小梁厚度、骨小梁数目和骨小梁分离度四种松质骨结构参数。并对各颞下颌关节骨关节病分期和骨质改变严重程度进行分类比较,应用SPSS 17.0统计软件对不同年龄层相互之间比较所获得的数据进行统计分析。结果:分析发现在142人中,女性发病率(73.3%)比男性(26.7%)更高,各年龄组女性患者发病率均显著高于男性患者,男女颞下颌关节骨关节病患者健康侧与患病侧的松质骨结构比较的结果均无统计学意义(P0.05)。与自身健康侧髁突相比,所有年龄组颞下颌关节骨关节病患者的患病侧松质骨的骨体积分数升高(P0.05);骨小梁厚度增厚(P0.05);骨小梁分离度无统计学的明显变化(P0.05)。40岁以下患者患侧的髁突松质骨的骨小梁数目减少(P0.05),而40岁以上患者患侧的骨小梁数目呈上升趋势,但无统计学意义(P0.05)。随着年龄增长,颞下颌关节骨关节病患者患病侧骨小梁厚度逐渐增厚(P0.05),骨小梁数目和分离度在部分年龄组之间有统计学差异(P0.05)。仅部分年龄组表现出与骨关节病分期和骨质破坏相关的松质骨结构变化(P0.05),但多数组间和组内比较结果无显著统计学意义(P0.05)。结论:与健康侧髁突相比,颞下颌关节骨关节病患者髁突松质骨在结构和形态上发生了特征性改变。随着年龄增长,骨关节病患者患病侧髁突松质骨形态学结构也发生了一些特征性改变。尚不能说明松质骨结构和年龄变化对颞下颌关节骨关节病不同分期和病态骨质变化严重程度有提示意义。
[Abstract]:Objective: to study the changes of cancellous bone structure of condylar process in temporomandibular osteoarthropathy (TMJ) at different ages. Methods: from 2007 to 2010, the clinic of temporomandibular joint (TMJ) of Peking University Stomatology Hospital was selected. 142 patients with temporomandibular joint osteoarthropathy were divided into 5 groups according to their age. They were divided into 5 groups: 30, 1829 years old, 30 years old, 40 49 years old, 50 59 years old and 60 years old. All patients underwent condylar CT scanning and selected the most typical coronal images of the healthy side and the diseased side of osteoarthropathy. A total of 284 images were obtained, and 142 images of the osteoarticular side and the normal control side were obtained. The CBCT images of the patients were interpreted to determine the stage and severity of the lesions. After image reconstruction, the images of the healthy side and the diseased side were imported into the image processing software, and the bone volume fraction and trabecular thickness of the diseased side and the healthy side were analyzed. The number of trabeculae and the separation degree of trabeculae were four parameters of cancellous bone structure. The stage and severity of temporomandibular osteoarthropathy were classified and compared. SPSS 17.0 software was used to analyze the data obtained from the comparison among different age groups. Results: among 142 people, the incidence rate of female was 73.3% higher than that of male (26.775%). The incidence of female patients in all age groups was significantly higher than that of male patients. There was no significant difference in the structure of cancellous bone between the healthy side and the diseased side in male and female patients with temporomandibular joint osteoarthritis (TMD) (P 0.05). Compared with the healthy lateral condyle, In all age groups, the bone volume fraction of the diseased cancellous bone was increased in patients with temporomandibular joint osteoarthritis (TMJ); the thickness of trabecular bone was thickened (P0.05); the degree of trabecular separation was not significantly changed; the degree of separation of bone trabeculae was not significantly changed in patients under 40 years of age. The number of bone trabeculae decreased and the number of bone trabeculae increased in patients over 40 years old. But there was no statistical significance (P 0.05). With the increase of age, the thickness of the trabeculae of temporomandibular joint became thicker than that of the patients with temporomandibular joint osteoarthritis, and the number of trabeculae and the degree of separation of trabeculae were significantly different among some age groups (P 0.05). Only some of the age groups showed the changes of cancellous bone structure related to the stage of osteoarthropathy and bone destruction, but there was no significant difference between most groups and within groups. Conclusion: the condylar cancellous bone in patients with temporomandibular joint osteoarthropathy is characterized by structural and morphological changes compared with the healthy lateral condyle. Some characteristic changes occurred in cancellous bone structure of lateral condylar process in patients with osteoarthropathy with age. It is not clear that the changes of cancellous bone structure and age have significance in different stages of temporomandibular joint osteoarthropathy and severity of pathological bone changes.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.6
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本文编号：1866656