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目的探讨单侧有症状的颞下颌关节紊乱病患者双侧颞下颌关节在CBCT成像上可能存在差异的参考层面,为颞下颌关节紊乱病诊断和对比研究提供参考。方法选取一侧TMJ有症状的TMD患者87例,通过CBCT三维成像和重建,观察同一患者两侧TMJ重建后横断面的水平角;平行于髁突长轴的斜位关节间隙、髁突长轴径值、髁突垂直角;垂直于髁突长轴的斜位与矢状位的关节结节斜度和关节间隙,采用SPSS13.0软件包对每位患者上述各测量指标做两配对样本t检验。结果两侧TMJ在平行位120°、矢状位60°和90°、垂直位60°和120°时的关节间隙测量值差异均有统计学意义(P<0.05),其中矢状位90°关节间隙的差异更显著(P<0.01),其余值均无统计学差异。结论对于单侧有症状的TMD患者,矢状位或垂直位是较易观察到左右两侧有差异的位置,在垂直位和矢状位均观察到前间隙的增大,在这个层面重建对诊断和对比研究更有意义。
Objective To explore the possible reference level of bilateral temporomandibular joint in patients with unilateral symptomatic TMJ disorders in CBCT imaging and provide a reference for the diagnosis and comparative study of temporomandibular disorder. Methods Eighty-seven TMD patients with TMJ symptomatic on one side were selected. Three-dimensional imaging and reconstruction of CBCT were performed to observe the horizontal cross-sectional angle of TMJ reconstruction on both sides of the same patient. The long axis of condylar was parallel to the long axis of condylar. Diameter and vertical angle of the condyle; the pitch and sagittal nodule tilt and joint space perpendicular to the long axis of the condyle, SPSS13.0 software package was used to make two paired samples for each patient test. Results There were significant differences in the measurement of joint space between the two sides of TMJ at 120 ° of parallel position, 60 ° and 90 ° of sagittal position, 60 ° and 120 ° of vertical position (P <0.05), and the sagittal position was 90 ° The difference of joint space was more significant (P <0.01), and the other values were not statistically different. Conclusions For patients with unilateral symptomatic TMD, the sagittal or vertical position is more readily observable with differences in the left and right sides, an increase of the anterior gap is observed both in the vertical and sagittal planes, and at this level the reconstruction pair Diagnostic and comparative studies make more sense.