本文選題：顳下頜關(guān)節(jié) + 斷面解剖��； 參考：《第三軍醫(yī)大學(xué)》2005年碩士論文

【摘要】：目的:①探討閉口位顳下頜關(guān)節(jié)盤及毗鄰結(jié)構(gòu)的形態(tài)特點及其臨床意義。②對照觀察閉口位、大開口位、下頜前伸位、下頜側(cè)移位等不同功能位顳下頜關(guān)節(jié)在橫、冠、矢三個方位的薄層斷面解剖形態(tài)及MRI 表現(xiàn),為顳下頜關(guān)節(jié)病變的影像診斷提供形態(tài)學(xué)依據(jù)。③建立閉口位、大開口位、下頜前伸位、下頜側(cè)移位顳下頜關(guān)節(jié)的三維數(shù)字化模型,為顳下頜關(guān)節(jié)外科手術(shù)計劃、演示以及關(guān)節(jié)鏡手術(shù)的模擬操作等提供幫助。方法:①測量31 側(cè)成人閉口位TMJ 關(guān)節(jié)盤,觀察關(guān)節(jié)盤及毗鄰結(jié)構(gòu)的形態(tài)特點及關(guān)系。②選取11 例新鮮尸頭,建立閉口位、大開口位、下頜前伸位、下頜側(cè)移位不同功能位TMJ 的實驗?zāi)Ｐ汀Ｈ￠]口位4 例,大開口位、頜前伸位、下頜側(cè)移位各1 例,共7 例(14 側(cè))顳下頜關(guān)節(jié)功能位標(biāo)本,利用生物塑化技術(shù)制成1mm 厚的軸位、斜矢狀位、斜冠狀位塑化薄層連續(xù)斷面;脫鈣處理4 例灌注鑄型劑的不同功能位的顳下頜關(guān)節(jié)標(biāo)本,利用低溫冰凍斷層切片技術(shù),切成0.9mm 厚的軸位、斜矢狀位、斜冠狀位連續(xù)薄層斷面,觀察不同功能位顳下頜關(guān)節(jié)斷層解剖形態(tài)。③選取4 例標(biāo)本、2 例青年志愿者,利用高場強MRI 成像儀對閉口位、大開口位、下頜前伸位、下頜側(cè)移位的雙側(cè)顳下頜關(guān)節(jié)行斜矢狀位、斜冠狀位、軸位三個方位掃描,觀察不同功能位顳下頜關(guān)節(jié)MRI 表現(xiàn)。④在SGI 工作站上重建不同功能位顳下頜關(guān)節(jié)的關(guān)節(jié)盤、髁突、下頜窩等結(jié)構(gòu)三維數(shù)字模型,并適時測量。 結(jié)果:①關(guān)節(jié)盤中間部分薄、周圍部分厚;中帶最薄,后帶最厚,其平均厚度為1.52 ±0.58mm;翼外肌上、下頭纖維在顳下頜關(guān)節(jié)囊前部集中,近關(guān)節(jié)囊區(qū)上頭肌纖維與翼外肌下頭肌纖維交叉,入盤的上、下頭肌纖維量非常有限;②不同功能位斷面標(biāo)本與MRI 對照觀察發(fā)現(xiàn),大開口位、下頜前伸位、下頜側(cè)移位非工作側(cè)關(guān)節(jié)盤與骨性關(guān)節(jié)面適應(yīng)性差,關(guān)節(jié)盤受壓,翼外肌表現(xiàn)同步收縮;而閉口位、側(cè)移位工作側(cè),關(guān)節(jié)盤無受壓,翼外肌上、下頭表現(xiàn)舒張。大開口位髁突向前下滑動并轉(zhuǎn)動,下頜前伸位、下頜側(cè)移位非工作側(cè)髁突發(fā)生滑動并在關(guān)節(jié)窩內(nèi)作復(fù)雜的轉(zhuǎn)動,下頜側(cè)移位工作側(cè)髁突僅發(fā)生轉(zhuǎn)動。③顳下頜關(guān)節(jié)的三維重建數(shù)字化模型直觀地反映了關(guān)節(jié)盤、髁突、下頜窩三者之間的解剖關(guān)系及關(guān)節(jié)盤的形態(tài)變化,在下頜前伸、側(cè)移位非工作側(cè)、大開口位時關(guān)節(jié)盤中帶受壓。三維適時測量顳下頜關(guān)節(jié),大開口位時關(guān)節(jié)盤形態(tài)變化最大,側(cè)移
[Abstract]:Objective to investigate the morphological features and clinical significance of the disc and adjacent structures of temporomandibular joint in closed position.The thin sectional anatomy and MRI features of the three sagittal directions provide morphological basis for the imaging diagnosis of temporomandibular joint diseases. 3. 3. The 3D digital model of temporomandibular joint (TMJ) was established in closed position, large opening position, mandibular extension position, mandibular lateral displacement and temporomandibular joint (TMJ) displacement.Provides assistance for temporomandibular joint surgery planning, presentation, and arthroscopic simulation.Methods 31 sides of adult TMJ articular disc in closed position were measured by 1: 1. The morphological characteristics and relationship of articular disc and adjacent structures were observed. 11 fresh cadaveric heads were selected to establish closed position, large opening position and mandibular anterior extension position.Experimental model of mandibular lateral displacement with different functional TMJ.The functional specimens of temporomandibular joint (TMJ) were taken from 4 cases of closed position, 4 cases of large opening position, 1 case of maxillary anterior extension, 1 case of mandibular lateral displacement, 7 cases of 14 sides of temporomandibular joint). The 1mm thick axial position, oblique sagittal position and oblique coronal position were plasticized and continuous sections were made by using biological plasticizing technique.Temporomandibular joint (TMJ) specimens at different functional positions were treated with decalcification. 0.9mm thick axial, oblique sagittal and oblique coronal sections were cut by cryogenic section technique.The anatomical morphology of temporomandibular joint (TMJ) in different functional positions was observed. 4 specimens were collected from 2 young volunteers. The closed position, the large opening position and the mandibular anterior extension position were observed by high field MRI imaging.The bilateral temporomandibular joints were scanned with oblique sagittal position, oblique coronal position and axial position. The MRI features of temporomandibular joint in different functional positions were observed. 4. The disc and condyle processes of temporomandibular joint were reconstructed on SGI workstation.Mandibular fossa isomorphic three-dimensional digital model, and timely measurement.Results the middle part of the disc was thin, the surrounding part was thick, the middle band was the thinnest and the posterior band was the thickest, the average thickness was 1.52 鹵0.58mm.The fibers of the inferior head were concentrated in the anterior part of the temporomandibular joint capsule on the lateral pterygoid muscle.The superior head muscle fiber in the proximal articular capsule crossed with the inferior head muscle fiber of the external pterygoid muscle. The volume of the lower head muscle fiber in the upper disc was very limited. The results showed that the large opening position and the mandibular anterior extension position were observed in the specimens of different functional positions compared with MRI.The lateral displacement of the mandibular side was not adapted to the bony articular surface, the joint disc was compressed and the lateral pterygoid muscle contracted synchronously, while in the closed position, the lateral displacement worked side, the disc was not compressed, the upper part of the lateral pterygoid muscle and the lower head of the lateral pterygoid muscle showed relaxation.The condyle slid forward and rotated in the large opening position, and the mandible extended forward, and the mandibular lateral displacement of the mandibular lateral condyle slid and made complex rotation in the articular fossa.The digital model of 3D reconstruction of temporomandibular joint (TMJ) of mandibular lateral displacement only showed the anatomical relationship among the disc, condyle and mandibular fossa, and the morphological changes of the articular disc.Lateral displacement of non-working side, large opening position of the articular disc compression.Three-dimensional measurement of temporomandibular joint, large opening position, the largest changes in the shape of the disc, lateral displacement
【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2005
【分類號】：R322

【引證文獻(xiàn)】

相關(guān)期刊論文 前2條

1 劉穎剛;;耳部部分裂、窩、管骨折的CT表現(xiàn)[J];臨床放射學(xué)雜志;2012年03期

2 劉穎剛;;耳部部分裂窩管的CT表現(xiàn)[J];中國臨床醫(yī)學(xué)影像雜志;2012年07期

相關(guān)碩士學(xué)位論文 前1條

1 王萍;正常與慢性關(guān)節(jié)彈響青年人顳下頜關(guān)節(jié)MRI研究[D];天津醫(yī)科大學(xué);2010年

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本文編號：1755029