本文選題：錐形束CT + 顳下頜關(guān)節(jié)��； 參考：《大連醫(yī)科大學》2017年碩士論文

【摘要】：目的:探討研究不同年齡層顳下頜關(guān)節(jié)骨關(guān)節(jié)病髁突松質(zhì)骨結(jié)構(gòu)變化特征。方法:選取2007年至2010年期間在北京大學口腔醫(yī)院顳下頜關(guān)節(jié)門診就診,并確診單側(cè)患病的顳下頜關(guān)節(jié)骨關(guān)節(jié)病的患者共142名(年齡18～82歲),按年齡將其分為5組:18～29歲,30～39歲,40～49歲,50～59歲及60歲以上,所有患者的雙側(cè)髁突均經(jīng)過錐形束CT掃描并且選擇最典型的健康側(cè)和骨關(guān)節(jié)病患病側(cè)冠狀位圖像,共獲取284幅圖像,骨關(guān)節(jié)病側(cè)和正常對照側(cè)各142幅圖像。判讀患者CBCT圖像,判斷其病變階段和病變程度。經(jīng)圖像重建后將健康側(cè)和患病側(cè)圖像導入自行研究開發(fā)的圖像處理軟件中進行處理,分析患病側(cè)與健康側(cè)的骨體積分數(shù)、骨小梁厚度、骨小梁數(shù)目和骨小梁分離度四種松質(zhì)骨結(jié)構(gòu)參數(shù)。并對各顳下頜關(guān)節(jié)骨關(guān)節(jié)病分期和骨質(zhì)改變嚴重程度進行分類比較,應(yīng)用SPSS 17.0統(tǒng)計軟件對不同年齡層相互之間比較所獲得的數(shù)據(jù)進行統(tǒng)計分析。結(jié)果:分析發(fā)現(xiàn)在142人中,女性發(fā)病率(73.3%)比男性(26.7%)更高,各年齡組女性患者發(fā)病率均顯著高于男性患者,男女顳下頜關(guān)節(jié)骨關(guān)節(jié)病患者健康側(cè)與患病側(cè)的松質(zhì)骨結(jié)構(gòu)比較的結(jié)果均無統(tǒng)計學意義(P0.05)。與自身健康側(cè)髁突相比,所有年齡組顳下頜關(guān)節(jié)骨關(guān)節(jié)病患者的患病側(cè)松質(zhì)骨的骨體積分數(shù)升高(P0.05);骨小梁厚度增厚(P0.05);骨小梁分離度無統(tǒng)計學的明顯變化(P0.05)。40歲以下患者患側(cè)的髁突松質(zhì)骨的骨小梁數(shù)目減少(P0.05),而40歲以上患者患側(cè)的骨小梁數(shù)目呈上升趨勢,但無統(tǒng)計學意義(P0.05)。隨著年齡增長,顳下頜關(guān)節(jié)骨關(guān)節(jié)病患者患病側(cè)骨小梁厚度逐漸增厚(P0.05),骨小梁數(shù)目和分離度在部分年齡組之間有統(tǒng)計學差異(P0.05)。僅部分年齡組表現(xiàn)出與骨關(guān)節(jié)病分期和骨質(zhì)破壞相關(guān)的松質(zhì)骨結(jié)構(gòu)變化(P0.05),但多數(shù)組間和組內(nèi)比較結(jié)果無顯著統(tǒng)計學意義(P0.05)。結(jié)論:與健康側(cè)髁突相比,顳下頜關(guān)節(jié)骨關(guān)節(jié)病患者髁突松質(zhì)骨在結(jié)構(gòu)和形態(tài)上發(fā)生了特征性改變。隨著年齡增長,骨關(guān)節(jié)病患者患病側(cè)髁突松質(zhì)骨形態(tài)學結(jié)構(gòu)也發(fā)生了一些特征性改變。尚不能說明松質(zhì)骨結(jié)構(gòu)和年齡變化對顳下頜關(guān)節(jié)骨關(guān)節(jié)病不同分期和病態(tài)骨質(zhì)變化嚴重程度有提示意義。
[Abstract]:Objective: to study the changes of cancellous bone structure of condylar process in temporomandibular osteoarthropathy (TMJ) at different ages. Methods: from 2007 to 2010, the clinic of temporomandibular joint (TMJ) of Peking University Stomatology Hospital was selected. 142 patients with temporomandibular joint osteoarthropathy were divided into 5 groups according to their age. They were divided into 5 groups: 30, 1829 years old, 30 years old, 40 49 years old, 50 59 years old and 60 years old. All patients underwent condylar CT scanning and selected the most typical coronal images of the healthy side and the diseased side of osteoarthropathy. A total of 284 images were obtained, and 142 images of the osteoarticular side and the normal control side were obtained. The CBCT images of the patients were interpreted to determine the stage and severity of the lesions. After image reconstruction, the images of the healthy side and the diseased side were imported into the image processing software, and the bone volume fraction and trabecular thickness of the diseased side and the healthy side were analyzed. The number of trabeculae and the separation degree of trabeculae were four parameters of cancellous bone structure. The stage and severity of temporomandibular osteoarthropathy were classified and compared. SPSS 17.0 software was used to analyze the data obtained from the comparison among different age groups. Results: among 142 people, the incidence rate of female was 73.3% higher than that of male (26.775%). The incidence of female patients in all age groups was significantly higher than that of male patients. There was no significant difference in the structure of cancellous bone between the healthy side and the diseased side in male and female patients with temporomandibular joint osteoarthritis (TMD) (P 0.05). Compared with the healthy lateral condyle, In all age groups, the bone volume fraction of the diseased cancellous bone was increased in patients with temporomandibular joint osteoarthritis (TMJ); the thickness of trabecular bone was thickened (P0.05); the degree of trabecular separation was not significantly changed; the degree of separation of bone trabeculae was not significantly changed in patients under 40 years of age. The number of bone trabeculae decreased and the number of bone trabeculae increased in patients over 40 years old. But there was no statistical significance (P 0.05). With the increase of age, the thickness of the trabeculae of temporomandibular joint became thicker than that of the patients with temporomandibular joint osteoarthritis, and the number of trabeculae and the degree of separation of trabeculae were significantly different among some age groups (P 0.05). Only some of the age groups showed the changes of cancellous bone structure related to the stage of osteoarthropathy and bone destruction, but there was no significant difference between most groups and within groups. Conclusion: the condylar cancellous bone in patients with temporomandibular joint osteoarthropathy is characterized by structural and morphological changes compared with the healthy lateral condyle. Some characteristic changes occurred in cancellous bone structure of lateral condylar process in patients with osteoarthropathy with age. It is not clear that the changes of cancellous bone structure and age have significance in different stages of temporomandibular joint osteoarthropathy and severity of pathological bone changes.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R782.6
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本文編號：1866656