颞下颌关节盘锚固术中锚固钉位置骨皮质厚度的CT测量分析

中国口腔颌面外科杂志 ›› 2016, Vol. 14 ›› Issue (6): 518-521.

颞下颌关节盘锚固术中锚固钉位置骨皮质厚度的CT测量分析

孙守福^*, 李慧萍^*, 张善勇, 郑吉驷, 甄锦泽, 徐伟峰, 郭克, 钟晓琪, 曲鹏宇

上海交通大学医学院附属第九人民医院·
口腔医学院口腔外科, 上海市口腔医学重点实验室,上海 200011

收稿日期:2016-05-11 修回日期:2016-07-18 出版日期:2016-11-20 发布日期:2016-12-05
通讯作者: 张善勇,E-mail:zhangshanyong@126.com;郑吉驷,E-mail:237111641@qq.com。^#共同通信作者
作者简介:孙守福（1990-）,男,硕士,住院医师,E-mail:sunshoufu@163.com;李慧萍（1992-）,女,硕士研究生,E-mail:lhp1992122@163.com。*并列第一作者

CT analysis of cortical bone thickness surrounding anchored nail position in temporomandibular joint disc anchoring operation

SUN Shou-fu, LI Hui-ping, ZHANG Shan-yong, ZHENG Ji-si, ZHEN Jin-ze, XU Wei-feng, GUO Ke, ZHONG Xiao-qi, QU Peng-yu

Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2016-05-11 Revised:2016-07-18 Online:2016-11-20 Published:2016-12-05

摘要/Abstract

摘要： 目的通过测量髁突颈后缘锚固钉植入位置骨皮质的厚度,为建立2种医用锚固钉植入髁突颈后缘拔出力的有限元模型分析提供数据参考。方法在本院拍摄CT的成年患者中,随机选取116例,共232侧髁突,利用CT采集颌面部数据并测量髁突颈后缘骨皮质厚度。采用SPSS17.0软件包进行统计学分析。结果 232侧髁突颈后缘骨皮质厚度均值为2.05 mm,男性骨皮质厚度均值为2.04 mm,女性骨皮质厚度均值为2.05 mm,两者之间无统计学差异;20~34岁髁突颈后缘骨皮质厚度均值为2.05 mm,35~49岁均值为2.06 mm,≥50岁均值为2.03mm。经统计学分析,只有20~34岁和35~49岁2组比较无显著差异（P>0.05）,其他2组之间均具有显著差异（P<0.05）。结论本实验为建立2种医用锚固钉植入髁突后缘拔出力分析的有限元模型奠定了基础,骨皮质厚度与锚固钉的稳定性有着重要关系。

关键词: 颞下颌关节盘锚固术, 髁突颈后缘, 骨皮质厚度, CT

Abstract: PURPOSE: To measure the thickness of cortical bone on the posterior margin of mandibular condyle neck where nails were anchored, and provide reference for pullout force finite element analysis of 2 types of nails anchored on the posterior margin of condyle neck. METHODS: One hundred and sixteen adult patients (total 232 sides of condyle) who had CT examination at our hospital were randomly selected. Maxillofacial data were collected through CT and the thickness of the posterior margin of condyle neck was measured and analyzed using SPSS17.0 software package. RESULTS: The mean cortical bone thickness on 232 sides of posterior margin of condyle neck was 2.05 mm, with an average thickness of 2.04 mm for men and 2.05 mm for women. No significant difference was documented between different genders. The mean thickness of cortical bone for the age group of 20-34 years were 2.05 mm, 2.06 mm for 35-49 years, and 2.03 mm for patients over 50 years, respectively. There were significant differences except group of 20-34 years and group of 35-49 years (P>0.05). CONCLUSIONS: This study can provide a reference for pullout force of finite element model of two implanted anchor nails. The cortical bone thickness has an important impact on the anchorage stability.

Key words: Temporomandibular joint disc anchorage, Posterior condylar neck flange, Cortical bone thickness, CT

中图分类号:

R782.6

孙守福, 李慧萍, 张善勇, 郑吉驷, 甄锦泽, 徐伟峰, 郭克, 钟晓琪, 曲鹏宇. 颞下颌关节盘锚固术中锚固钉位置骨皮质厚度的CT测量分析[J]. 中国口腔颌面外科杂志, 2016, 14(6): 518-521.

SUN Shou-fu, LI Hui-ping, ZHANG Shan-yong, ZHENG Ji-si, ZHEN Jin-ze, XU Wei-feng, GUO Ke, ZHONG Xiao-qi, QU Peng-yu. CT analysis of cortical bone thickness surrounding anchored nail position in temporomandibular joint disc anchoring operation[J]. China J Oral Maxillofac Surg, 2016, 14(6): 518-521.

参考文献

[1] 张志愿, 俞光岩. 口腔颌面外科学 [M]. 第7版. 北京: 人民卫生出版社, 2012: 376.
[2] 孙守福, 张善勇, 杨驰. 颞下颌关节盘锚固术应用进展 [J]. 中国口腔颌面外科, 2016, 14(2): 179-182.
[3] 张善勇, 陈敏洁, 姜滨, 等. 关节盘锚固术治疗中晚期TMJ结构紊乱的临床效果 [J]. 中国口腔颌面外科杂志, 2008, 6(6): 415-420.
[4] Motoyoshi M, Inaba M, Ono A, et al. The effect of cortical bone thickness on the stability of orthodontic mini-implants and on the stress distribution in surrounding bone [J]. Int J Oral Maxillofac Surg, 2009, 38(1) : 13-18.
[5] 赵岩, 吴平. 应用锥形束CT探究上颌前牙区颌骨微种植支抗钉植入的安全区[J]. 实用口腔医学杂志, 2012, 28(4): 486-489.
[6] 顾永佳, 陆胜男, 高美琴. 不同垂直骨面型成人下颌骨皮质厚度的锥形束CT研究 [J]. 上海口腔医学, 2015, 24(3): 335-337.
[7] 马嘉, 卢利, 宋丛笑. 下颌前突患者下颌支厚度的CT测量 [J].上海口腔医学, 2007, 16(6): 607-610.
[8] Mehra P, Wolford LM. Use of the Mitek anchor in temporomandibular joint disc-repositioning surgery [J]. Proc (Bayl Univ Med Cent), 2001, 14(1): 22-26.
[9] 王洋, 严维, 张子璇, 等. 不同垂直骨面型青少年上颌后牙骨皮质密度的CBCT测量 [J]. 宜春学院学报, 2013, 35(12): 75-77.
[10] 王谋, 张定铭, 周建萍, 等. 后牙区颊侧牙槽骨微植体支抗植入区域骨皮质厚度CBCT测量分析 [J].重庆医科大学学报, 2012, 37(2): 147-150.
[11] 林颋旭, 陶列. 正畸用微种植体上颌磨牙植入区骨皮质厚度的测量分析 [J].上海口腔医学, 2011, 20(6): 645-647.
[12] 肖遥, 罗茂璇. CBCT评价儿童上后牙颊侧微种植体支抗植入部位的骨皮质厚度 [J]. 重庆医学, 2015, 44(2): 221-223.
[13] Al-Jandan BA, Al-Sulaiman AA, Marei HF, et a1. Thickness of buccal bone in the mandible and its clinical significance in mono-cortical screws placement. A CBCT analysis [J]. Int J Oral Maxillofac Surg, 2013, 42(11): 77-81.
[14] Dalstra M, Cattaneo PM, Melsen B. Load transfer of miniscrews for orthodontic anchorage [J]. Orthodontics, 2004, 1(1): 53-62.
[15] Maki K, Okano T, Morohashi T, et a1. The application of three dimensional quantitative computed tomography to the maxillofacial skeleton[J]. Dentomaxillofac Radiol, 1997, 26(1): 39-44.
[16] Poole KE, Mayhew PM. Changing structure of the femoral neck across the adult female life span [J]. Bone Miner Res, 2010,25(3):482-491.