Magnetic resonance imaging in the assessment of the temporomandibular joint structure following mandibular advancement

目的 研究安氏Ⅱ类1分类错(牙合)患者功能前徙下颌后颞下颌关节(temporomandibular joint,TMJ)盘-突-窝位置关系的改变,探讨功能矫治对TMJ结构产生的影响.方法 25例安氏Ⅱ类1分类错(牙合)患者(男性10例,女性15例),平均(11.1±1.1)岁(8.1～13.0岁),接受Activator功能矫治,平均疗程10.9个月,矫治效果满意.治疗前后分别对患者TMJ进行MRI扫描检查并用配对t检验进行盘-突-窝位置关系的定量对比分析.结果 治疗前后左侧TMJ髁突前缘与关节窝拐点的距离(Ca-Tm)[分别为(-0.1±1.5)mm和(-0.6±0.9)mm]、右侧TMJ关节前间隙(Ca-Ca')[分别为(2.3±0.8)mm和(1.8±0.5)mm]的差异有统计学意义(P＜0.05),反映髁突向前移位.反映双侧关节盘在关节窝中位置的各测量项目治疗前后的差异均无统计学意义(P＞0.05).反映双侧关节盘相对于髁突位置的各测量项目治疗前后的差异均无统计学意义(P＞0.05).结论 功能矫治安氏Ⅱ类1分类错(牙合)在促进下颌发育、改善患者(牙合)-颌-面畸形的同时,不会对TMJ功能产生不利影响,相反可能有助于改善患者治疗前存在的不良的TMJ功能状态.To investigate the changes in the disc-condyle-fossa relationship following mandibular advancement.Twenty-five patients (10 boys and 15 girls, 11.1 +/- 1.1 years) with class II division 1 malocclusions were treated with Activator. The average treatment time was 10.9 months. Parasagittal MRIs in closed mouth position were analyzed before and after Activator treatment by means of the pair-t test.Ca-Tm value [(-0.1 +/- 1.5) mm and (-0.6 +/- 0.9) mm] of the left temporomandibular joint (TMJ) and Ca-Ca' value [(2.3 +/- 0.8) mm and (1.8 +/- 0.5) mm] of the right TMJ were changed significantly after Activator treatment (P < 0.05). This indicated that the condyle was located anteriorly in the fossa. No significant changes were found in the disc-fossa relationship and disc-condyle relationship (P > 0.05).Activator could promote the growth of the mandible and at the same time, it had no apparent negative influence on TMJ function.PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)011665-6684