伴深覆（牙合）的颞下颌关节紊乱病患者的CBCT测量分析
发布时间：2019-06-18 19:13
【摘要】：目的:应用CBCT比较伴深覆（牙合）的颞下颌关节紊乱病患者与个别正常（牙合）人群髁突形态及关节间隙之间的差异,探究伴深覆（牙合）的颞下颌关节紊乱病患者的颞下颌关节形态特征。初步探讨深覆（牙合）这一（牙合）因素与TMD的关系,拟为TMD的诊断和早期防治提供参考。方法:选取30例确诊为颞下颌关节紊乱病且前牙为深覆（牙合）的患者作为实验组。选取双侧颞下颌关节健康的个别正常（牙合）人群30例作为对照组。应用New Tom 5G CBCT分别对各实验对象的牙尖交错位时的双侧颞下颌关节扫描成像,使用NNT-Viewer对图像处理图像并进行三维重建。在轴位、矢状位、冠状位三个层面上选定测量平面并进行参数测量。应用SPSS19.0统计学软件对各项测量数据进行分析处理。结果:1、个别正常（牙合）组(对照组)左右两侧关节结构测量数据差异无统计学意义(P0.05)。2、伴深覆（牙合）的颞下颌关节紊乱病患者组(实验组)右侧关节窝平均深度为8.76±0.87mm,左侧关节窝平均深度为8.35±1.01mm,右侧深度大于左侧,且差异有统计学意义(P0.05);左右侧其余测量数值无统计学差异(P0.05)。3、Vitral法测得的对照组的关节前间隙平均值为2.01±0.65mm,小于实验组的关节前间隙平均值2.37±0.60mm,差异有统计学意义(P0.05);对照组的关节上间隙为3.04±0.65mm,大于实验组的关节上间隙平均值2.55±0.62mm,差异有统计学意义(P0.05);对照组的关节后间隙为1.91±0.69mm,大于实验组的关节后间隙平均值1.64±0.42mm,差异有统计学意义(P0.05)。张震康法测得的对照组关节前间隙平均值为2.09±0.66mm,小于实验组的关节前间隙平均值2.50±0.62mm,差异有统计学意义(P0.05);对照组的关节上间隙为3.05±0.67mm,大于实验组的关节上间隙平均值2.56±0.94mm,差异有统计学意义(P0.05);对照组的关节后间隙为2.06±0.70mm,大于实验组的关节后间隙平均值1.81 ±0.47mm。对照组和实验组的其余测量值差异均无统计学意义(P0.05)。Vitral法和张震康法测得的实验组的关节前间隙均大于对照组,关节上间隙、后间隙均小于对照组,差异有统计学意义(P0.05)。结论:1、个别正常（牙合）人群双侧颞下颌关节结构基本对称。2、伴深覆（牙合）的颞下颌关节紊乱病患者左右侧关节窝深度存在差异。3、伴深覆（牙合）的颞下颌关节紊乱病患者关节前间隙变大,后间隙、上间隙变小,髁突位置较个别正常（牙合）人群向后、上方移位。4、CBCT能较好地显示颞下颌关节骨性结构及关节间隙的改变。
[Abstract]:Objective: to compare the condylar morphology and joint space between patients with TMJ with deep occlusion (occlusal) and individual normal subjects by CBCT, and to explore the morphological characteristics of TMJ in patients with TMJ with deep occlusion (occlusal). To explore the relationship between occlusal (occlusal) and TMD, so as to provide reference for the diagnosis and early prevention and treatment of TMD. Methods: 30 patients with TMJ and deep overbite (occlusal) were selected as experimental group. 30 cases of healthy bilateral TMJ (occlusal) were selected as the control group. New Tom 5G CBCT was used to scan the bilateral TMJ during apical dislocation, and NNT-Viewer was used to process the image and reconstruct the image. The measuring plane is selected and the parameters are measured on the axial, sagittal and coronal planes. SPSS19.0 statistical software was used to analyze and process the measured data. Results: 1 there was no significant difference in the measured data of left and right joint structure in individual normal (occlusal) group (control group). 2. The average depth of right joint fossa was 8.76 卤0.87 mm, the average depth of left joint fossa was 8.35 卤1.01 mm, and the right depth was significantly higher than that of left side in the group of patients with deep occlusion (experimental group) (P < 0.05), and the average depth of right joint fossa was 8.76 卤0.87 mm, and the depth of left joint fossa was 8.35 卤1.01 mm, and the depth of right joint fossa was higher than that of left side (P 0.05). There was no significant difference in the other measured values between the left and right sides (P 0.05). 3, the average anterior space of the control group was 2.01 卤0.65 mm, which was lower than that of the experimental group (2.37 卤0.60 mm, P 0.05), and that of the control group was 3.04 卤0.65 mm, which was significantly higher than that of the experimental group (2.55 卤0.62 mm). The posterior space of the control group was 1.91 卤0.69 mm, which was significantly higher than that of the experimental group (1.64 卤0.42 mm) (P 0.05). The average value of anterior joint space measured by Zhang Zhenkang method was 2.09 卤0.66 mm, which was lower than that of the experimental group (2.50 卤0.62 mm, P 0.05), and that of the control group was 3.05 卤0.67 mm, which was higher than that of the experimental group (2.56 卤0.94 mm), the difference was statistically significant (P 0.05), and the average value of the anterior joint space of the control group was 2.09 卤0.66 mm, which was significantly lower than that of the experimental group (2.50 卤0.62 mm). The posterior space of the control group was 2.06 卤0.70mm, which was larger than that of the experimental group (1.81 卤0.47mm). There was no significant difference in the other measured values between the control group and the experimental group (P 0.05). The anterior space of the experimental group measured by Vitale method and Zhang Zhenkang method was larger than that of the control group, and the supraarticular space and posterior space were smaller than those of the control group, and the difference was statistically significant (P 0.05). Conclusion: 1. The structure of bilateral TMJ in individual normal (occlusal) population is basically symmetrical. 2, there is a difference in the depth of left and right joint fossa in patients with TMJ disorder with deep occlusion (occlusal). 3, the anterior space, posterior space and superior space of TMJ with deep occlusion (occlusal) become larger, posterior space and superior space become smaller, and the condylar position is backward and superior than that of individual normal (occlusal) population. CBCT can show the changes of bone structure and joint space of TMJ.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.6
本文编号：2501721
[Abstract]:Objective: to compare the condylar morphology and joint space between patients with TMJ with deep occlusion (occlusal) and individual normal subjects by CBCT, and to explore the morphological characteristics of TMJ in patients with TMJ with deep occlusion (occlusal). To explore the relationship between occlusal (occlusal) and TMD, so as to provide reference for the diagnosis and early prevention and treatment of TMD. Methods: 30 patients with TMJ and deep overbite (occlusal) were selected as experimental group. 30 cases of healthy bilateral TMJ (occlusal) were selected as the control group. New Tom 5G CBCT was used to scan the bilateral TMJ during apical dislocation, and NNT-Viewer was used to process the image and reconstruct the image. The measuring plane is selected and the parameters are measured on the axial, sagittal and coronal planes. SPSS19.0 statistical software was used to analyze and process the measured data. Results: 1 there was no significant difference in the measured data of left and right joint structure in individual normal (occlusal) group (control group). 2. The average depth of right joint fossa was 8.76 卤0.87 mm, the average depth of left joint fossa was 8.35 卤1.01 mm, and the right depth was significantly higher than that of left side in the group of patients with deep occlusion (experimental group) (P < 0.05), and the average depth of right joint fossa was 8.76 卤0.87 mm, and the depth of left joint fossa was 8.35 卤1.01 mm, and the depth of right joint fossa was higher than that of left side (P 0.05). There was no significant difference in the other measured values between the left and right sides (P 0.05). 3, the average anterior space of the control group was 2.01 卤0.65 mm, which was lower than that of the experimental group (2.37 卤0.60 mm, P 0.05), and that of the control group was 3.04 卤0.65 mm, which was significantly higher than that of the experimental group (2.55 卤0.62 mm). The posterior space of the control group was 1.91 卤0.69 mm, which was significantly higher than that of the experimental group (1.64 卤0.42 mm) (P 0.05). The average value of anterior joint space measured by Zhang Zhenkang method was 2.09 卤0.66 mm, which was lower than that of the experimental group (2.50 卤0.62 mm, P 0.05), and that of the control group was 3.05 卤0.67 mm, which was higher than that of the experimental group (2.56 卤0.94 mm), the difference was statistically significant (P 0.05), and the average value of the anterior joint space of the control group was 2.09 卤0.66 mm, which was significantly lower than that of the experimental group (2.50 卤0.62 mm). The posterior space of the control group was 2.06 卤0.70mm, which was larger than that of the experimental group (1.81 卤0.47mm). There was no significant difference in the other measured values between the control group and the experimental group (P 0.05). The anterior space of the experimental group measured by Vitale method and Zhang Zhenkang method was larger than that of the control group, and the supraarticular space and posterior space were smaller than those of the control group, and the difference was statistically significant (P 0.05). Conclusion: 1. The structure of bilateral TMJ in individual normal (occlusal) population is basically symmetrical. 2, there is a difference in the depth of left and right joint fossa in patients with TMJ disorder with deep occlusion (occlusal). 3, the anterior space, posterior space and superior space of TMJ with deep occlusion (occlusal) become larger, posterior space and superior space become smaller, and the condylar position is backward and superior than that of individual normal (occlusal) population. CBCT can show the changes of bone structure and joint space of TMJ.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.6
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