青少年双侧颞下颌关节盘前移位与下颌后缩的相关性研究

发布时间：2018-03-06 10:39

本文选题：青少年　切入点：双侧　出处：《上海交通大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：研究青少年双侧颞下颌关节（Temporomandibular Joint, TMJ）盘前移位（Anterior Disc Displacement，ADD）与下颌后缩（Mandibular Retrusion MR）的相关性。分析青少年双侧ADD患者中MR的发生率及矢状向面型特征，探讨ADD与MR的相关因素；并通过青少年双侧ADD患者的随访研究，了解ADD的自然转归及其与青少年下颌骨生长发育的关系，初步探究ADD与MR的因果关系。方法：收集自2009年9月至2013年12月间在上海交通大学附属第九人民医院口腔外科关节专科同一位医生处就诊的经颞下颌关节磁共振（MagneticResonance Image，MRI）检查确诊为双侧ADD的20岁以下（含20岁）青少年患者174例，对所有患者进行关节MRI和X线头颅定位侧位片检查和测量，评价关节及下颌后缩情况；采用Pearson相关性分析研究病程、发病年龄与ADD病变程度及MR程度的相互关系。对其中部分患者进行至少半年的随访，复查关节MRI和X线头颅定位侧位片，重新评价关节病变及下颌后缩情况，采用配对t检验比较随访期前后的关节及面型的变化。结果：患者平均年龄16.7岁，SNB角为76.04°±3.61°，其中MR患者89例(51.1%)。双侧ADD患者发病年龄越早，病程越长，则关节盘移位越严重，关节盘变短，下颌后缩也越明显(p0.05)。对38例患者（平均年龄17.2岁）经过13.0个月（6个月~49个月）随访，关节盘移位距离增加0.92mm(p0.05)，关节盘长度缩短0.58mm(p0.05)，髁突高度下降0.64mm(p0.05)，SNB角没有明显改变(p0.05)，下颌平面角和Y轴角均增大(p0.05)。结论：青少年双侧ADD与MR具有显著相关性。双侧ADD患者中MR发生率高于正常人群，，且ADD发病年龄越早，病程越长，则关节盘移位距离越大、关节盘变形越重，髁突生长发育受限，下颌后缩也越严重。双侧ADD的自然转归导致盘移位病变程度的加重，髁突高度降低，下颌呈顺时针旋转趋势。由此推测双侧TMJADD可能是MR发生或加重的重要原因之一。
[Abstract]:Objective: to study the correlation between bilateral temporomandibular joint (TMJ) and mandibular posterior Disc displacement (ADDD) and to analyze the incidence and sagittal features of Mr in bilateral ADD, and to explore the correlation factors between ADD and Mr. The natural outcome of ADD and its relationship with the growth and development of juvenile mandible were studied by follow-up study of bilateral ADD in adolescents. The causal relationship between ADD and Mr was preliminarily explored. Methods: from September 2009 to December 2013, 20 cases of bilateral ADD diagnosed by magnetic resonance imaging (MRI) of temporomandibular joint (TMJ) were collected from 9th people's Hospital affiliated to Shanghai Jiaotong University. 174 cases of adolescent patients under the age of 20 years, All the patients were examined and measured with MRI and X-ray lateral radiographs to evaluate the joint and mandibular retraction, and the course of disease was studied by Pearson correlation analysis. The relationship between the age of onset and the degree of ADD and Mr. Some of the patients were followed up for at least half a year. The lateral radiographs of MRI and X-ray were reexamined to evaluate the joint lesion and mandibular retraction. T-test was used to compare the changes of joint and facial shape before and after follow-up. Results: the average age of the patients was 76.04 掳卤3.61 掳, of which 89 cases with Mr were 51.1%. The earlier the onset age and the longer the course of bilateral ADD, the more severe the displacement of the articular disc and the shorter the joint disc. 38 patients (mean age 17.2 years) were followed up for 13.0 months (6-49 months). The displacement distance of the articular disc was increased by 0.92mm, the length of the articular disc was shortened by 0.58mm, the height of the condylar process was decreased by 0.64mm, the SNB angle was not changed significantly, the mandibular plane angle and the Y-axis angle were increased. Conclusion: there is a significant correlation between bilateral ADD and Mr in adolescents. The incidence of Mr in patients with bilateral ADD is higher than that in normal subjects. The earlier the onset age of ADD is and the longer the course of disease is, the greater the distance of displacement of joint disc is and the more severe the deformation of articular disc is. The condyle growth and development are limited and the mandibular retraction is more serious. The natural outcome of bilateral ADD results in the severity of disc displacement and the decrease of condylar height. The mandible rotates clockwise, which suggests that bilateral TMJADD may be one of the important causes of Mr.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R782.6

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