伴深覆（牙合）的顳下頜關(guān)節(jié)紊亂病患者的CBCT測量分析
發(fā)布時間：2019-06-18 19:13
【摘要】：目的:應(yīng)用CBCT比較伴深覆（牙合）的顳下頜關(guān)節(jié)紊亂病患者與個別正常（牙合）人群髁突形態(tài)及關(guān)節(jié)間隙之間的差異,探究伴深覆（牙合）的顳下頜關(guān)節(jié)紊亂病患者的顳下頜關(guān)節(jié)形態(tài)特征。初步探討深覆（牙合）這一（牙合）因素與TMD的關(guān)系,擬為TMD的診斷和早期防治提供參考。方法:選取30例確診為顳下頜關(guān)節(jié)紊亂病且前牙為深覆（牙合）的患者作為實驗組。選取雙側(cè)顳下頜關(guān)節(jié)健康的個別正常（牙合）人群30例作為對照組。應(yīng)用New Tom 5G CBCT分別對各實驗對象的牙尖交錯位時的雙側(cè)顳下頜關(guān)節(jié)掃描成像,使用NNT-Viewer對圖像處理圖像并進(jìn)行三維重建。在軸位、矢狀位、冠狀位三個層面上選定測量平面并進(jìn)行參數(shù)測量。應(yīng)用SPSS19.0統(tǒng)計學(xué)軟件對各項測量數(shù)據(jù)進(jìn)行分析處理。結(jié)果:1、個別正常（牙合）組(對照組)左右兩側(cè)關(guān)節(jié)結(jié)構(gòu)測量數(shù)據(jù)差異無統(tǒng)計學(xué)意義(P0.05)。2、伴深覆（牙合）的顳下頜關(guān)節(jié)紊亂病患者組(實驗組)右側(cè)關(guān)節(jié)窩平均深度為8.76±0.87mm,左側(cè)關(guān)節(jié)窩平均深度為8.35±1.01mm,右側(cè)深度大于左側(cè),且差異有統(tǒng)計學(xué)意義(P0.05);左右側(cè)其余測量數(shù)值無統(tǒng)計學(xué)差異(P0.05)。3、Vitral法測得的對照組的關(guān)節(jié)前間隙平均值為2.01±0.65mm,小于實驗組的關(guān)節(jié)前間隙平均值2.37±0.60mm,差異有統(tǒng)計學(xué)意義(P0.05);對照組的關(guān)節(jié)上間隙為3.04±0.65mm,大于實驗組的關(guān)節(jié)上間隙平均值2.55±0.62mm,差異有統(tǒng)計學(xué)意義(P0.05);對照組的關(guān)節(jié)后間隙為1.91±0.69mm,大于實驗組的關(guān)節(jié)后間隙平均值1.64±0.42mm,差異有統(tǒng)計學(xué)意義(P0.05)。張震康法測得的對照組關(guān)節(jié)前間隙平均值為2.09±0.66mm,小于實驗組的關(guān)節(jié)前間隙平均值2.50±0.62mm,差異有統(tǒng)計學(xué)意義(P0.05);對照組的關(guān)節(jié)上間隙為3.05±0.67mm,大于實驗組的關(guān)節(jié)上間隙平均值2.56±0.94mm,差異有統(tǒng)計學(xué)意義(P0.05);對照組的關(guān)節(jié)后間隙為2.06±0.70mm,大于實驗組的關(guān)節(jié)后間隙平均值1.81 ±0.47mm。對照組和實驗組的其余測量值差異均無統(tǒng)計學(xué)意義(P0.05)。Vitral法和張震康法測得的實驗組的關(guān)節(jié)前間隙均大于對照組,關(guān)節(jié)上間隙、后間隙均小于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1、個別正常（牙合）人群雙側(cè)顳下頜關(guān)節(jié)結(jié)構(gòu)基本對稱。2、伴深覆（牙合）的顳下頜關(guān)節(jié)紊亂病患者左右側(cè)關(guān)節(jié)窩深度存在差異。3、伴深覆（牙合）的顳下頜關(guān)節(jié)紊亂病患者關(guān)節(jié)前間隙變大,后間隙、上間隙變小,髁突位置較個別正常（牙合）人群向后、上方移位。4、CBCT能較好地顯示顳下頜關(guān)節(jié)骨性結(jié)構(gòu)及關(guān)節(jié)間隙的改變。
[Abstract]:Objective: to compare the condylar morphology and joint space between patients with TMJ with deep occlusion (occlusal) and individual normal subjects by CBCT, and to explore the morphological characteristics of TMJ in patients with TMJ with deep occlusion (occlusal). To explore the relationship between occlusal (occlusal) and TMD, so as to provide reference for the diagnosis and early prevention and treatment of TMD. Methods: 30 patients with TMJ and deep overbite (occlusal) were selected as experimental group. 30 cases of healthy bilateral TMJ (occlusal) were selected as the control group. New Tom 5G CBCT was used to scan the bilateral TMJ during apical dislocation, and NNT-Viewer was used to process the image and reconstruct the image. The measuring plane is selected and the parameters are measured on the axial, sagittal and coronal planes. SPSS19.0 statistical software was used to analyze and process the measured data. Results: 1 there was no significant difference in the measured data of left and right joint structure in individual normal (occlusal) group (control group). 2. The average depth of right joint fossa was 8.76 鹵0.87 mm, the average depth of left joint fossa was 8.35 鹵1.01 mm, and the right depth was significantly higher than that of left side in the group of patients with deep occlusion (experimental group) (P < 0.05), and the average depth of right joint fossa was 8.76 鹵0.87 mm, and the depth of left joint fossa was 8.35 鹵1.01 mm, and the depth of right joint fossa was higher than that of left side (P 0.05). There was no significant difference in the other measured values between the left and right sides (P 0.05). 3, the average anterior space of the control group was 2.01 鹵0.65 mm, which was lower than that of the experimental group (2.37 鹵0.60 mm, P 0.05), and that of the control group was 3.04 鹵0.65 mm, which was significantly higher than that of the experimental group (2.55 鹵0.62 mm). The posterior space of the control group was 1.91 鹵0.69 mm, which was significantly higher than that of the experimental group (1.64 鹵0.42 mm) (P 0.05). The average value of anterior joint space measured by Zhang Zhenkang method was 2.09 鹵0.66 mm, which was lower than that of the experimental group (2.50 鹵0.62 mm, P 0.05), and that of the control group was 3.05 鹵0.67 mm, which was higher than that of the experimental group (2.56 鹵0.94 mm), the difference was statistically significant (P 0.05), and the average value of the anterior joint space of the control group was 2.09 鹵0.66 mm, which was significantly lower than that of the experimental group (2.50 鹵0.62 mm). The posterior space of the control group was 2.06 鹵0.70mm, which was larger than that of the experimental group (1.81 鹵0.47mm). There was no significant difference in the other measured values between the control group and the experimental group (P 0.05). The anterior space of the experimental group measured by Vitale method and Zhang Zhenkang method was larger than that of the control group, and the supraarticular space and posterior space were smaller than those of the control group, and the difference was statistically significant (P 0.05). Conclusion: 1. The structure of bilateral TMJ in individual normal (occlusal) population is basically symmetrical. 2, there is a difference in the depth of left and right joint fossa in patients with TMJ disorder with deep occlusion (occlusal). 3, the anterior space, posterior space and superior space of TMJ with deep occlusion (occlusal) become larger, posterior space and superior space become smaller, and the condylar position is backward and superior than that of individual normal (occlusal) population. CBCT can show the changes of bone structure and joint space of TMJ.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R782.6
本文編號：2501721
[Abstract]:Objective: to compare the condylar morphology and joint space between patients with TMJ with deep occlusion (occlusal) and individual normal subjects by CBCT, and to explore the morphological characteristics of TMJ in patients with TMJ with deep occlusion (occlusal). To explore the relationship between occlusal (occlusal) and TMD, so as to provide reference for the diagnosis and early prevention and treatment of TMD. Methods: 30 patients with TMJ and deep overbite (occlusal) were selected as experimental group. 30 cases of healthy bilateral TMJ (occlusal) were selected as the control group. New Tom 5G CBCT was used to scan the bilateral TMJ during apical dislocation, and NNT-Viewer was used to process the image and reconstruct the image. The measuring plane is selected and the parameters are measured on the axial, sagittal and coronal planes. SPSS19.0 statistical software was used to analyze and process the measured data. Results: 1 there was no significant difference in the measured data of left and right joint structure in individual normal (occlusal) group (control group). 2. The average depth of right joint fossa was 8.76 鹵0.87 mm, the average depth of left joint fossa was 8.35 鹵1.01 mm, and the right depth was significantly higher than that of left side in the group of patients with deep occlusion (experimental group) (P < 0.05), and the average depth of right joint fossa was 8.76 鹵0.87 mm, and the depth of left joint fossa was 8.35 鹵1.01 mm, and the depth of right joint fossa was higher than that of left side (P 0.05). There was no significant difference in the other measured values between the left and right sides (P 0.05). 3, the average anterior space of the control group was 2.01 鹵0.65 mm, which was lower than that of the experimental group (2.37 鹵0.60 mm, P 0.05), and that of the control group was 3.04 鹵0.65 mm, which was significantly higher than that of the experimental group (2.55 鹵0.62 mm). The posterior space of the control group was 1.91 鹵0.69 mm, which was significantly higher than that of the experimental group (1.64 鹵0.42 mm) (P 0.05). The average value of anterior joint space measured by Zhang Zhenkang method was 2.09 鹵0.66 mm, which was lower than that of the experimental group (2.50 鹵0.62 mm, P 0.05), and that of the control group was 3.05 鹵0.67 mm, which was higher than that of the experimental group (2.56 鹵0.94 mm), the difference was statistically significant (P 0.05), and the average value of the anterior joint space of the control group was 2.09 鹵0.66 mm, which was significantly lower than that of the experimental group (2.50 鹵0.62 mm). The posterior space of the control group was 2.06 鹵0.70mm, which was larger than that of the experimental group (1.81 鹵0.47mm). There was no significant difference in the other measured values between the control group and the experimental group (P 0.05). The anterior space of the experimental group measured by Vitale method and Zhang Zhenkang method was larger than that of the control group, and the supraarticular space and posterior space were smaller than those of the control group, and the difference was statistically significant (P 0.05). Conclusion: 1. The structure of bilateral TMJ in individual normal (occlusal) population is basically symmetrical. 2, there is a difference in the depth of left and right joint fossa in patients with TMJ disorder with deep occlusion (occlusal). 3, the anterior space, posterior space and superior space of TMJ with deep occlusion (occlusal) become larger, posterior space and superior space become smaller, and the condylar position is backward and superior than that of individual normal (occlusal) population. CBCT can show the changes of bone structure and joint space of TMJ.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R782.6
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