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目的 通过评价锥体束CT(cone beam computed tomography,CBCT)影像改变,探讨颞下颌关节重度骨关节病伴牙(牙合)面畸形患者的髁突骨改变的稳定性.方法 选取2007年至2012年初诊为颞下颌关节重度骨关节病伴咬合紊乱/牙(牙合)面畸形且有半年/1年追踪资料的患者共113例,其中103例为双侧病变,10例为单侧病变,共计216侧关节,年龄10~40岁,平均年龄(20.6±6.0)岁.获取CBCT影像资料评估随访半年和/或一年后髁突骨质改变情况.结果 初诊时髁突表面光整者,半年后骨改变进展率为25.6%,一年后为23.5%,无统计学差异(P>0.05).髁突表面不光整者,半年后骨改变进展率为45.6%,一年后为29.2%,有统计学差异(P<0.05).结论 颞下颌关节重度骨关节病髁突表面光整者,骨质较为稳定.相反,髁突表面不光整者,半年内骨改变进展可能性较大,一年后骨质趋向稳定.“,”Objective To investigate the stability of the osseous changes of the condylar bone in patients diagnosed with severe temporomandibular joint osteoarthrosis (TMJ OA) with malocclusion and/or maxillofacial deformities using cone beam computed tomography (CBCT).Methods 113 individuals,aged between 10 and 40 years old with an average age of 20.6±6.0 years,diagnosed with severe TMJ OA with mal(c)(c)clusion and/or facial deformities and were were recruited.Bilateral TMJs were involved in 103 patients and unilateral TMJ was involved in 10 patients,with a total of 216 TMJs.CBCT images were used to evaluate condylar bony changes after a short-term (half year) and a long-term (one year) follow-up.Results CBCT images of the severe TMJ OA at the first visit were classified as 2 types:with smooth condylar surface (type A) and with no smooth condylar surface (type B).The progression rate of the type A condyle was 25.6% after half year and 23.5% after one year respectively (P>0.05).However,the progression rate of the type B condyle was 45.6% after half year and 29.2% after one year respectively,with a significant difference (P<0.05).Conclusions The condylar bone with severe TMJ OA with smooth surface was relatively stable in both short and long term.However,the condyles with no smooth surface were highly possible to progress in half year,and tended to become stable after one year.