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目的应用锥形束CT测量颞下颌关节间隙,探讨偏侧咀嚼对颞下颌关节间隙的影响。方法颞下颌关节紊乱病患者30例,其中有左侧咀嚼习惯15例(左侧咀嚼组),右侧咀嚼习惯15例(右侧咀嚼组),锥形束CT扫描重建获得轴位、冠状位、矢状位图像,然后选取经髁突横轴外l/3矢状层面测量颞下颌关节前、上、后间隙,并与符合试验设计的30例健康成人(对照组)进行比较。结果左侧咀嚼组左、右侧关节前间隙[(2.95±0.53)、(2.78±0.67)mm]、上间隙[(3.02±0.56)、(3.00±0.47)mm]大于对照组[(1.79±0.46)、(2.24±0.69)mm;(2.39±0.51)、(2.21±0.80)mm],差异有统计学意义(P<0.05);右侧咀嚼组左、右侧关节前间隙[(2.68±0.56)、(2.75±0.51)mm]、上间隙[(3.20±0.95)、(3.23±0.83)mm]大于对照组,差异有统计学意义(P<0.05);左侧咀嚼组与右侧咀嚼组左、右侧关节前、上、后间隙比较差异无统计学意义(P>0.05)。结论偏侧咀嚼可使颞下颌关节前间隙、上间隙增宽,双侧髁突位置向下向后移位。
Objective To measure the temporomandibular joint space by conical beam CT and investigate the influence of unilateral chewing on temporomandibular joint space. Methods Thirty patients with temporomandibular disorder were involved in this study. Among them, there were 15 cases of left chewing habit (left chewing group) and 15 cases of right chewing habit (right chewing group). Cone beam CT scan was used to reconstruct axial and coronal , Sagittal images were collected. The anterior, posterior, superior and posterior space of temporomandibular joint were measured by lateral l 3/3 sagittal lateral condyle and compared with 30 healthy adults (control group) that conformed to the experimental design. Results The left and right preganglionic space [(2.95 ± 0.53), (2.78 ± 0.67) mm] and the upper space (3.02 ± 0.56, 3.00 ± 0.47 mm) in the left chewing group were significantly higher than those in the control group [(1.79 ± (2.24 ± 0.69) mm; (2.39 ± 0.51), (2.21 ± 0.80) mm], the difference was statistically significant (P <0.05) 0.56, 2.75 ± 0.51, and 3.20 ± 0.95, 3.23 ± 0.83, respectively], which were significantly higher than those in the control group (P <0.05). The left chewing group and the right chewing group There was no significant difference in the anterior, posterior, posterior and posterior articular left and right joints (P> 0.05). Conclusion Unilateral chewing can make the temporomandibular joint anterior gap, the gap widened, bilateral condyle position backward and backward shift.