髁突特发性吸收的临床观察

中国口腔颌面外科杂志 ›› 2014, Vol. 12 ›› Issue (6): 509-514.

髁突特发性吸收的临床观察

熊玮, 苏凯, 郑有华, 何一青, 匡世军, 张志光

中山大学光华口腔医学院·
附属口腔医院口腔医学研究所,广东广州 510055

收稿日期:2014-01-22 出版日期:2014-11-10 发布日期:2015-01-01
通讯作者: 郑有华,Tel：020-83812523,E-mail：zhengyhgz@qq.com
作者简介:熊玮（1987-）,女,硕士研究生,E-mail：
基金资助:
卫生部属（管）医院临床学科重点项目[卫规财（2010) 439]; 中山大学临床医学研究5010计划项目（2007050）

Clinical investigation of the idiopathic condyle resorption

XIONG Wei, SU Kai, ZHENG You-hua, HE Yi-qing, KUANG Shi-jun, ZHANG Zhi-guang

Institute of Stomatology, Guanghua school of Stomatology, Sun Yat-sen University. Guangzhou 510055, Guangdong Province, China

Received:2014-01-22 Online:2014-11-10 Published:2015-01-01
Supported by:
Supported by Key Clinical Program of Ministry of Health of China [(2010)439] and Sun Yat-sen University Clinical Research 5010 Program (2007050)

摘要/Abstract

摘要： 目的通过对髁突特发性吸收（idiopathic condylar resorption,ICR）患者临床资料的回顾性分析,总结ICR的临床特点和影像学特点,探讨ICR可能的发病因素,提高诊断水平。方法收集2007年6月—2012年7月中山大学附属口腔医院颞下颌关节病诊治中心收治的ICR患者46例,对其进行随访观察。记录患者面型、颞下颌关节症状及咬合状况;借助全景片、头颅定位正侧位片、许勒位片检查,以了解患者下颌支高度、髁突骨质破坏情况、颅面结构特征等影像学变化,借助颞下颌关节锥形束CT（CBCT）检查及造影检查,了解髁突吸收与关节盘-突结构改变之间的关系。结果 46例患者中,男4例,女42例（91.30%）,以青少年为主。患者均呈安氏Ⅱ类面型,侧貌突,侧貌不美观,下颌骨后缩,下颌支高度降低,前牙开、后牙早接触、安氏Ⅱ类错。多伴关节区弹响、杂音。X线平片显示,髁突形态变小甚至消失;下颌支垂直距离变短;头影测量呈安氏Ⅱ类高角型特征;TMJ CBCT造影示关节盘-突关系改变,尤其以关节盘穿孔较为常见,穿孔位置多在关节盘后区。结论 ICR具有独特的发病机制和临床特征。TMJ关节盘移位与ICR可能存在相关性。

关键词: 颞下颌关节, 髁突, 特发性吸收, 关节盘穿孔

Abstract: PURPOSE : To summarize the clinical and imaging characteristics of idiopathic condylar resorption (ICR) and investigate the pathogenic factors and susceptible factors of ICR. METHODS : Forty-six ICR patients were included who were treated between 2007 and 2012. The clinical data was collected. The facial type, condition of TMJ and occlusion were recorded. On X-ray films, the ramus height, destruction of condyle, craniofacial features were evaluated. Correlation between condylar resorption and the position relationship between the disc and the condyle were assessed by arthrography with Cone-beam CT (CBCT). RESULTS : Idiopathic condylar resorption often occurred in females (42 cases, 91.30%) and teenagers. The patients had a common facial morphology including skeletal and occlusal high-angle Class II deformity, anterior open bite, high occlusal plane angle and mandibular plane angle, progressively retruding mandible. The patients always had TMJ symptoms, such as joint sound. X-ray film showed extreme thinness or loss of continuity of cortical bone on the head of the condyle and vertical height of the ramus decreased. TMJ disc perforation could be observed by arthrography with CBCT. The position of perforation was always on the posterior of disc. CONCLUSIONS : ICR has its own unique pathogenesis and clinical features. There is correlation between TMJ disc displacement and ICR, Disc displacement may reinforce and promote ICR, and vice versa.

Key words: Temporomandibular joint, Condyle, Idiopathic resorption, Disc perforation

中图分类号:

R782.6

熊玮, 苏凯, 郑有华, 何一青, 匡世军, 张志光. 髁突特发性吸收的临床观察[J]. 中国口腔颌面外科杂志, 2014, 12(6): 509-514.

XIONG Wei, SU Kai, ZHENG You-hua, HE Yi-qing, KUANG Shi-jun, ZHANG Zhi-guang. Clinical investigation of the idiopathic condyle resorption[J]. China J Oral Maxillofac Surg, 2014, 12(6): 509-514.

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