髁突骨质改变的CBCT研究

发布时间：2018-01-02 18:18

  本文关键词：髁突骨质改变的CBCT研究　出处：《天津医科大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 髁突 骨质改变 特发性髁突吸收 颅颌面 下颌骨 锥体束CT

【摘要】：目的:髁突与颞下颌关节(temporomandibular joint,TMJ)、牙合关系、下颌骨以及面部形态密切相关,因此,髁突骨质情况改变是口腔各科医师研究和关注的重点。本实验通过对髁突骨质改变患者的锥体束CT(cone-beam computed tomography,CBCT)资料分析,探讨其年龄、性别分布特点,并进一步对特发性髁突吸收(idiopathic condylar resorption,ICR)患者的颅颌面CBCT指标进行统计学分析,研究其颅颌面的影像学特点。方法:从2012年11月至2014年11月期间在天津医科大学口腔医院拍摄CBCT的患者资料中选取髁突骨质改变的患者,对患者的左右两侧髁突分别进行CBCT资料的分析。根据髁突的骨质改变类型将患者分为五组,髁突磨平变短(Flattening,F)组,髁突骨质侵蚀(Erosion,E)组,髁突骨质吸收(Resorption,R)组,髁突骨质硬化(Sclerosis,S)组,髁突骨赘形成(Osteophyte,O)组。采用SPSS17.0软件统计分析髁突骨质改变患者的年龄、性别分布特点,并针对每一组骨质改变类型,统计每组中骨质改变者与无骨质改变者的平均年龄是否存在统计学差异。然后根据临床及CBCT资料记录,从髁突吸收组中筛选出ICR患者作为试验组(ICR组),并将其分为单侧ICR组和双侧ICR组;从天津医科大学的学生中选取关节正常的健康志愿者作为对照组(正常组),并拍摄CBCT,应用Invivo5软件读取所有试验对象的CBCT数据资料,定位标记点,测量颅颌面的各相关指标,并进行统计学分析。结果:试验一:1.髁突骨质改变患者共计266例,男女比例为1:2.4,女性患者明显多于男性,且10-39岁年龄段患者占总患病人数的62.8%;女性患者在20-29岁患病人数出现明显高峰。2.每组髁突骨质改变类型中,骨质硬化者的平均年龄明显高于无骨质硬化者的平均年龄,差异有统计学意义(P0.05);骨质吸收者的平均年龄明显小于无骨质吸收者的平均年龄,差异有统计学意义(P0.05);其他骨质变化类型中的骨质改变者与无骨质改变者,其平均年龄之间的差异无统计学意义(P0.05)。试验二:1.正常组及双侧ICR组的左右两侧指标的差异无统计学意义(P0.05);2.ICR组中患侧的SNB、NP-FH、FH-SGn、L1-MP、S-Go、S-Go/N-Me、Co-Go、髁高、前后径、后斜面长、前斜面角均小于正常组同侧,ANB、SN-MP、S-Ar-Go、Co-Go-Me大于正常组同侧,其差异有统计学意义(P0.05),而SNA、U1-LI、U1-NA、L1-NB、N-Me、Go-Me、S-Co、前斜面长、后斜面角均无统计学意义(P0.05);3.单侧ICR组中患侧的S-Go、Co-Go、髁高、前后径、后斜面长、前斜面角均小于对侧,S-Ar-Go、Co-Go-Me大于对侧,其差异有统计学意义(P0.05),SNB、ANB、SN-MP、NP-FH、FH-SGn、SNA、U1-LI、U1-NA、L1-NB、L1-MP、N-Me、S-Go/N-Me、Go-Me、S-Co、前斜面长、后斜面角均无统计学意义(P0.05)。结论:1.髁突骨质改变患者中,女性明显多于男性,且好发年龄为10-39岁,女性患者高发年龄集中在20-29岁。2.髁突骨质改变类型中,骨质硬化者的发病年龄较晚;骨质吸收者的发病年龄较早。3.ICR具有明显的青春期女性发病倾向,是一种特发于髁突的骨吸收性疾病,而下颌骨的其他部位不受影响,这种吸收主要发生于髁突的顶端和前斜面,以髁突高度的降低为主要表现。4.当髁突吸收累及双侧时可出现下颌后缩,此为下颌骨后下旋转引起,而非髁突后移导致;若累及单侧,则患侧下颌骨发生后下旋转,而正常侧向前上旋转,使得面型偏斜且偏向患侧。
[Abstract]:Objective: the condyle and temporomandibular joint (temporomandibular joint, TMJ), occlusal relationship, closely related, and therefore the facial morphology of mandibular condylar bone, the change is the focus of research and attention to oral doctors. Through the study of condylar bone changes in pyramidal patients with CT (cone-beam computed tomography, CBCT) data analysis, to investigate the age, gender distribution, and further to idiopathic condylar resorption (idiopathic condylar, resorption, ICR) in patients with craniofacial CBCT index were statistically analyzed, research characteristics of the craniofacial imaging. Methods: during the period from November 2012 to November 2014 in Stomatological Hospital Affiliated to Tianjin Medical University shooting selected patients with condylar bone change the CBCT data analysis, CBCT data of patients with left and right sides of the condyle. The condylar bone changes according to the type of patients were divided into five groups, condyle Sudden down shorter (Flattening, F) group, condylar bone erosion (Erosion, E) group, condylar bone resorption (Resorption, R) group, condylar bone sclerosis (Sclerosis, S) group, condylar osteophyte formation (Osteophyte, O) group. The SPSS17.0 software was used for statistical analysis of condylar bone change the patient's age, gender distribution, and for each group of bone changes in type, and no bone changes the average age of the existence of significant difference in each group. The change of bone statistics according to clinical and CBCT data recording, absorption group ICR patients were selected as experimental group from condyle (ICR group). It is divided into unilateral ICR group and bilateral ICR group; selection of joint normal healthy volunteers from the Medical University Of Tianjin students as the control group (normal group), and shooting CBCT, using Invivo5 software to read CBCT data on all subjects, the location of markers, the measurement of the craniofacial The index, and analyzed statistically. Results: the results of experiment: 1. condylar bone changes in patients with a total of 266 cases, male to female ratio was 1:2.4, significantly higher than that in male and female patients, aged 10-39 patients accounted for the total number of 62.8%; in women aged 20-29 prevalence change obvious peak of condylar bone type in.2. group the average age of bone sclerosis, were significantly higher than the average age of bone sclerosis, the difference was statistically significant (P0.05); mean age of bone resorption were significantly less than those without bone resorption, the difference was statistically significant (P0.05); other types of changes of bone and bone changes without bone changes and there was no significant difference between the average age (P0.05). Experiment two: no statistically significant difference between the normal group and the 1. group of bilateral ICR on both sides of the index (P0.05); group 2.ICR in the ipsilateral SNB, NP-FH, FH-SG n,L1-MP,S-Go,S-Go/N-Me,Co-Go,楂侀珮,鍓嶅悗寰，

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