本文關(guān)鍵詞：髁突骨質(zhì)改變的CBCT研究　出處：《天津醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 髁突 骨質(zhì)改變 特發(fā)性髁突吸收 顱頜面 下頜骨 錐體束CT

【摘要】：目的:髁突與顳下頜關(guān)節(jié)(temporomandibular joint,TMJ)、牙合關(guān)系、下頜骨以及面部形態(tài)密切相關(guān),因此,髁突骨質(zhì)情況改變是口腔各科醫(yī)師研究和關(guān)注的重點。本實驗通過對髁突骨質(zhì)改變患者的錐體束CT(cone-beam computed tomography,CBCT)資料分析,探討其年齡、性別分布特點,并進(jìn)一步對特發(fā)性髁突吸收(idiopathic condylar resorption,ICR)患者的顱頜面CBCT指標(biāo)進(jìn)行統(tǒng)計學(xué)分析,研究其顱頜面的影像學(xué)特點。方法:從2012年11月至2014年11月期間在天津醫(yī)科大學(xué)口腔醫(yī)院拍攝CBCT的患者資料中選取髁突骨質(zhì)改變的患者,對患者的左右兩側(cè)髁突分別進(jìn)行CBCT資料的分析。根據(jù)髁突的骨質(zhì)改變類型將患者分為五組,髁突磨平變短(Flattening,F)組,髁突骨質(zhì)侵蝕(Erosion,E)組,髁突骨質(zhì)吸收(Resorption,R)組,髁突骨質(zhì)硬化(Sclerosis,S)組,髁突骨贅形成(Osteophyte,O)組。采用SPSS17.0軟件統(tǒng)計分析髁突骨質(zhì)改變患者的年齡、性別分布特點,并針對每一組骨質(zhì)改變類型,統(tǒng)計每組中骨質(zhì)改變者與無骨質(zhì)改變者的平均年齡是否存在統(tǒng)計學(xué)差異。然后根據(jù)臨床及CBCT資料記錄,從髁突吸收組中篩選出ICR患者作為試驗組(ICR組),并將其分為單側(cè)ICR組和雙側(cè)ICR組;從天津醫(yī)科大學(xué)的學(xué)生中選取關(guān)節(jié)正常的健康志愿者作為對照組(正常組),并拍攝CBCT,應(yīng)用Invivo5軟件讀取所有試驗對象的CBCT數(shù)據(jù)資料,定位標(biāo)記點,測量顱頜面的各相關(guān)指標(biāo),并進(jìn)行統(tǒng)計學(xué)分析。結(jié)果:試驗一:1.髁突骨質(zhì)改變患者共計266例,男女比例為1:2.4,女性患者明顯多于男性,且10-39歲年齡段患者占總患病人數(shù)的62.8%;女性患者在20-29歲患病人數(shù)出現(xiàn)明顯高峰。2.每組髁突骨質(zhì)改變類型中,骨質(zhì)硬化者的平均年齡明顯高于無骨質(zhì)硬化者的平均年齡,差異有統(tǒng)計學(xué)意義(P0.05);骨質(zhì)吸收者的平均年齡明顯小于無骨質(zhì)吸收者的平均年齡,差異有統(tǒng)計學(xué)意義(P0.05);其他骨質(zhì)變化類型中的骨質(zhì)改變者與無骨質(zhì)改變者,其平均年齡之間的差異無統(tǒng)計學(xué)意義(P0.05)。試驗二:1.正常組及雙側(cè)ICR組的左右兩側(cè)指標(biāo)的差異無統(tǒng)計學(xué)意義(P0.05);2.ICR組中患側(cè)的SNB、NP-FH、FH-SGn、L1-MP、S-Go、S-Go/N-Me、Co-Go、髁高、前后徑、后斜面長、前斜面角均小于正常組同側(cè),ANB、SN-MP、S-Ar-Go、Co-Go-Me大于正常組同側(cè),其差異有統(tǒng)計學(xué)意義(P0.05),而SNA、U1-LI、U1-NA、L1-NB、N-Me、Go-Me、S-Co、前斜面長、后斜面角均無統(tǒng)計學(xué)意義(P0.05);3.單側(cè)ICR組中患側(cè)的S-Go、Co-Go、髁高、前后徑、后斜面長、前斜面角均小于對側(cè),S-Ar-Go、Co-Go-Me大于對側(cè),其差異有統(tǒng)計學(xué)意義(P0.05),SNB、ANB、SN-MP、NP-FH、FH-SGn、SNA、U1-LI、U1-NA、L1-NB、L1-MP、N-Me、S-Go/N-Me、Go-Me、S-Co、前斜面長、后斜面角均無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1.髁突骨質(zhì)改變患者中,女性明顯多于男性,且好發(fā)年齡為10-39歲,女性患者高發(fā)年齡集中在20-29歲。2.髁突骨質(zhì)改變類型中,骨質(zhì)硬化者的發(fā)病年齡較晚;骨質(zhì)吸收者的發(fā)病年齡較早。3.ICR具有明顯的青春期女性發(fā)病傾向,是一種特發(fā)于髁突的骨吸收性疾病,而下頜骨的其他部位不受影響,這種吸收主要發(fā)生于髁突的頂端和前斜面,以髁突高度的降低為主要表現(xiàn)。4.當(dāng)髁突吸收累及雙側(cè)時可出現(xiàn)下頜后縮,此為下頜骨后下旋轉(zhuǎn)引起,而非髁突后移導(dǎo)致;若累及單側(cè),則患側(cè)下頜骨發(fā)生后下旋轉(zhuǎn),而正常側(cè)向前上旋轉(zhuǎn),使得面型偏斜且偏向患側(cè)。
[Abstract]:Objective: the condyle and temporomandibular joint (temporomandibular joint, TMJ), occlusal relationship, closely related, and therefore the facial morphology of mandibular condylar bone, the change is the focus of research and attention to oral doctors. Through the study of condylar bone changes in pyramidal patients with CT (cone-beam computed tomography, CBCT) data analysis, to investigate the age, gender distribution, and further to idiopathic condylar resorption (idiopathic condylar, resorption, ICR) in patients with craniofacial CBCT index were statistically analyzed, research characteristics of the craniofacial imaging. Methods: during the period from November 2012 to November 2014 in Stomatological Hospital Affiliated to Tianjin Medical University shooting selected patients with condylar bone change the CBCT data analysis, CBCT data of patients with left and right sides of the condyle. The condylar bone changes according to the type of patients were divided into five groups, condyle Sudden down shorter (Flattening, F) group, condylar bone erosion (Erosion, E) group, condylar bone resorption (Resorption, R) group, condylar bone sclerosis (Sclerosis, S) group, condylar osteophyte formation (Osteophyte, O) group. The SPSS17.0 software was used for statistical analysis of condylar bone change the patient's age, gender distribution, and for each group of bone changes in type, and no bone changes the average age of the existence of significant difference in each group. The change of bone statistics according to clinical and CBCT data recording, absorption group ICR patients were selected as experimental group from condyle (ICR group). It is divided into unilateral ICR group and bilateral ICR group; selection of joint normal healthy volunteers from the Medical University Of Tianjin students as the control group (normal group), and shooting CBCT, using Invivo5 software to read CBCT data on all subjects, the location of markers, the measurement of the craniofacial The index, and analyzed statistically. Results: the results of experiment: 1. condylar bone changes in patients with a total of 266 cases, male to female ratio was 1:2.4, significantly higher than that in male and female patients, aged 10-39 patients accounted for the total number of 62.8%; in women aged 20-29 prevalence change obvious peak of condylar bone type in.2. group the average age of bone sclerosis, were significantly higher than the average age of bone sclerosis, the difference was statistically significant (P0.05); mean age of bone resorption were significantly less than those without bone resorption, the difference was statistically significant (P0.05); other types of changes of bone and bone changes without bone changes and there was no significant difference between the average age (P0.05). Experiment two: no statistically significant difference between the normal group and the 1. group of bilateral ICR on both sides of the index (P0.05); group 2.ICR in the ipsilateral SNB, NP-FH, FH-SG n,L1-MP,S-Go,S-Go/N-Me,Co-Go,楂侀珮,鍓嶅悗寰，

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