前方牵引矫治替牙期骨性Ⅲ类错畸形后颞下颌关节结构变化的CT测量研究

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目的应用螺旋CT扫描技术,研究前方牵引矫治替牙期骨性Ⅲ类错畸形患者治疗前后髁状突与关节窝结构的变化。方法选择替牙期骨性Ⅲ类错畸形病例15例,年龄6.7~10.3岁,采用前方牵引进行矫治。经PHILIPS公司16排螺旋CT常规扫描后进行头颅三维重建。取颞下颌关节正中矢状位图像分析关节前间隙、关节上间隙、关节后间隙、关节窝深度及关节结节后壁角度。采用配对t检验,比较治疗前后髁状突与关节窝结构的改变。结果患者治疗前后,关节前间隙、关节窝深度、关节结节后壁角度变化无统计学差异,关节上间隙、关节后间隙减小,且有统计学差异。结论前方牵引矫治替牙期骨性安氏Ⅲ类错畸形后,关节上间隙及关节后间隙减小,髁状突上后移。 Objective To study the changes of condyle and jugular fossa before and after treatment in patients with skeletal Class Ⅲ malocclusion by frontal traction and helical CT scanning. Methods Fifteen cases of skeletal Class Ⅲ malocclusion were selected, aged from 6.7 to 10.3 years old, and treated with anterior traction. The 16-slice spiral CT by Philips PHILIPS routine scan three-dimensional reconstruction of the skull. The temporomandibular joint median sagittal images were taken to analyze the anterior joint space, the joint space, the joint space, the depth of the joint socket and the angle of the joint nodules. Paired t test was used to compare the changes of condyle and glenoid fossa before and after treatment. Results Before and after treatment, there was no significant difference in the ankle joint, the depth of the joint fossa, the angle of the posterior joint nodule, and the gap between the joint and the joint after the treatment. There was a statistically significant difference. Conclusions In the treatment of skeletal Class Ⅲ malocclusion with skeletal Class Ⅱ malocclusion, the upper and lower posterior joint space are reduced and the condyle is laterally displaced.
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