颞下颌关节骨性三维测量标准的建立及在骨关节病中的应用

中国口腔颌面外科杂志 ›› 2016, Vol. 14 ›› Issue (1): 14-18.

颞下颌关节骨性三维测量标准的建立及在骨关节病中的应用

白果¹，何冬梅^1*，杨驰^1*，张露珠¹，王飞宇¹，董敏俊²，常雨丝¹

1.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;
2.上海交通大学医学院附属第九人民医院放射科,上海 200011

收稿日期:2015-03-18 出版日期:2016-01-20 发布日期:2016-02-01
通讯作者: 何冬梅,E-mail:lucyhe119@163.com;杨驰,Tel:021-23271699-5218, E-mail:yangchi63@hotmail.com。*共同通信作者
作者简介:白果（1989-）,男,硕士,住院医师,E-mail：surgeonb@163.com
基金资助:
国家自然科学基金（81472117）; 上海交通大学医工交叉基金（YG2014MS05）; 上海市科学技术委员会科研计划项目（14DZ2294300）;上海交通大学医学院第九期大学生创新训练项目（2015502)

3D-measurement of temporomandibular joint morphology and preliminary use in osteoarthritis

BAI Guo¹, HE Dong-mei¹, YANG Chi¹, ZHANG Lu-zhu¹, WANG Fei-yu¹, DONG Min-jun², CHANG Yu-si¹

1.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;
2. Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China

Received:2015-03-18 Online:2016-01-20 Published:2016-02-01

摘要/Abstract

摘要： 目的建立颞下颌关节骨性结构的三维测量标准,并对人工关节置换的骨关节病患者进行测量和健、患侧比较,为假体的选择提供依据。方法采用Proplan CMF 1.4软件,在CT扫描三维重建的基础上确立颞下颌关节的骨性测量标准,对2005年3月—2014年12月间收治的12例行单侧人工关节置换的骨关节病患者进行三维测量并与健侧比较,采用SAS 6.1软件包对关节窝及髁突的骨性形态进行统计学分析。结果骨关节病的颞下颌关节与健侧相比,在关节窝外侧深度、颧弓根宽度、髁突头高度和下颌支长度方面存在显著差异;而在关节窝前后径和内外径、关节窝前斜面角度、关节结节高度、颧弓根厚度、髁突内倾角和后仰角,以及髁突的宽度和角度方面无显著差异。结论本研究建立了颞下颌关节的骨性三维测量标准和人工颞下颌关节国产化设计的重要参考指标;初步发现骨关节病患者的关节窝较扁平、髁突头高度减低、下颌支长度短于健侧。

关键词: 颞下颌关节, 骨性结构, 三维测量, 骨关节病

Abstract: PURPOSE : To establish a new 3D-measurement method of temporomandibular joint (TMJ) and make comparison of TMJ osseous morphology of the affected and contralateral side in patients with unilateral osteoarthritis, and preliminarily study TMJ osseous remodeling of the affected side. METHODS : Patients who were diagnosed with unilateral TMJ osteoarthritis and needed total replacement surgery from Mar. 2005 to Dec. 2014 were included in this study. Physical examination and TMJ magnetic resonance image (MRI) were taken to ensure the contralateral joint was healthy. Cranial-maxillofacial computed tomography (CT) of each patient was taken and imported into Proplan CMF 1.4 software to reconstruct the skull and a new 3D-measurement method of TMJ osseous morphology was established. Paired t test was used to evaluate the difference between the affected and contralateral side in patients with unilateral osteoarthritis using SAS 6.1 software package. RESULTS : The lateral depth of glenoid fossa, the sagittal diameter of condyle, the height condylar head, the width of zygomatic arch and the length of ramus on the affected side were significantly different from the contralateral side (P<0.05). However, the medially inclining angle of condyle, the retrally leaning angle of condyle, the sagittal diameter and horizontal diameter of glenoid fossa, the anterior slope angle of glenoid fossa, the height of articular eminence, the thickness of zygomatic arch, the width of anterior and posterior slope of condyle, the sagittal diameters of condyle and condylar neck on the affected side all showed no significant differences from the contralateral side (P>0.05). CONCLUSIONS : The 3D-measurement method of osseous morphology of TMJ was built, which provided the anatomy reference for design of TMJ prosthesis. The preliminary RESULTS of comparison between the affected and contralateral side in unilateral osteoarthritis patients showed that the affected side had a relatively flat glenoid fossa and less condylar head height as well as ramus length than the healthy side.

Key words: Temporomandibular joint, Osseous morphology, 3-D measurement, Osteoarthritis

中图分类号:

R782.6

白果，何冬梅，杨驰，张露珠，王飞宇，董敏俊，常雨丝. 颞下颌关节骨性三维测量标准的建立及在骨关节病中的应用[J]. 中国口腔颌面外科杂志, 2016, 14(1): 14-18.

BAI Guo, HE Dong-mei, YANG Chi, ZHANG Lu-zhu, WANG Fei-yu, DONG Min-jun, CHANG Yu-si. 3D-measurement of temporomandibular joint morphology and preliminary use in osteoarthritis[J]. China J Oral Maxillofac Surg, 2016, 14(1): 14-18.

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