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目的应用锥形束CT(CBCT)研究分析单侧后牙正锁患者的双侧髁突形态及其在关节窝内位置的差异,以及正锁解除后,患者髁突形态及位置的代偿性改建情况,以期为正畸临床诊疗提供早期依据。方法选择单侧后牙正锁18~28岁患者20例为实验组,同期选择安氏Ⅰ类轻度拥挤错颌18~30岁患者25例为对照组,进行面部锥形束CT拍摄,利用3D Examvision成像系统软件进行三维重建,描记测量髁突形态及位置的点和线,对7个不同的测量值进行统计学分析。结果正畸治疗前,对照组左右两侧髁突形态及其在关节窝内的位置差异无统计学意义(P>0.05),实验组正锁侧关节窝深度及髁突高度高于非锁侧,差异具有统计学意义(t=13.271,t=15.278,P<0.01)。正畸治疗正锁并稳定保持3个月后,实验组正锁侧关节前间隙、关节后间隙变化与治疗前相比差异具有统计学意义(t=5.524,t=-5.119,P<0.01),关节前间隙治疗前大于治疗后;关节后间隙治疗前小于治疗后。实验组非锁侧治疗前后髁突形态及其位置变化的差异无统计学意义(P>0.05)。结论单侧后牙正锁患者双侧髁突形态及其在关节窝内的位置存在差异,矫治正锁并稳定保持3个月后,锁侧关节有向前下移动的趋势,而髁突形态并无明显变化。
OBJECTIVE: To study the morphological changes of bilateral condyle of unilateral posterior teeth in patients with unilateral posterior teeth and its position in the joint socket by cone beam computed tomography (CBCT) study. Compensatory reconstruction, with a view to provide early evidence for clinical diagnosis and treatment of orthodontics. Methods 20 cases of unilateral posterior locking 正 positive locking 18 ~ 28 years old patients were selected as the experimental group, 25 cases of Angle Ⅰ class Ⅰ patients with mild congested miscrossed jaw 18 ~ 30 years old were selected as the control group, Using 3D Examvision imaging system software for 3D reconstruction, tracing the points and lines of condyle shape and location, and making statistical analysis on seven different measured values. Results Before orthodontic treatment, there was no significant difference in condyle shape between the left and right sides of the control group and its position in the joint socket (P> 0.05). The depth of the joint socket and the height of the condyle in the test group were higher than those without the lock side, the difference was statistically significant (t = 13.271, t = 15.278, P <0.01). After 3 months of orthodontic treatment, the gap between the anterior commissure and the posterior joint of the experimental group was statistically significant (t = 5.524, t = -5.119, P < 0.01). The anterior gap was larger than the anterior gap before treatment. The anterior gap was less than before treatment. There was no significant difference in condyle shape and position between the experimental group and non-occlusion side (P> 0.05). Conclusions The bilateral condyle shape and its position in the joint socket of unilateral posterior locking positive lock are different. After correction of positive lock and stable holding for 3 months, the lock lateral joint has the tendency to move forward and downward. Condyle morphology did not change significantly.