口腔医学研究

口腔医学研究 ›› 2018, Vol. 34 ›› Issue (8): 870-875.DOI: 10.13701/j.cnki.kqyxyj.2018.08.017

• 颞下颌关节与颌骨研究 • 上一篇    下一篇

正畸治疗对下颌髁突肥大术后颞下颌关节的影响

梁昌富1, 陈国新2*, 肖秀凤2, 孙辉2, 郑雅蕾2   

  1. 1. 海南医学院附属第二医院口腔科 海南 海口 570102;
    2. 武汉大学口腔医院中商广场门诊部 湖北 武汉 430079
  • 收稿日期:2018-02-01 出版日期:2018-08-28 发布日期:2018-08-23
  • 通讯作者: 陈国新,电话:(027)87265508
  • 作者简介:梁昌富(1980~ ),男,海南人,主治医师,学士,主要从事口腔正畸临床及研究工作。
  • 基金资助:
    湖北省自然科学基金面上项目(编号:ZRY2014000905)

Influence of Orthodontic Treatment on Temporomandibular Joint after Surgery of Condylar Hyperplasia

LIANG Chang-fu1, CHEN Guo-xin2*, XIAO Xiu-feng2, SUN Hui2, ZHENG Ya-lei2   

  1. 1. Department of Stomatology, Affiliated Second Hospital of Hainan Medical College. Haikou 570102, China;
    2. School of Stomatology, Wuhan University ,Wuhan 430079, China
  • Received:2018-02-01 Online:2018-08-28 Published:2018-08-23

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摘要： 目的:评价正畸治疗对下颌髁突肥大术后颞下颌关节的影响,并探讨其术后关节的稳定性。方法:下颌髁突肥大高位切除术后转诊患者20例,男8例,女12例,年龄17~34岁,平均21.2岁,采用固定或隐形正畸治疗,种植钉压低患侧上颌后牙。术前、术后及正畸后进行颞下颌关节功能对比,常规拍摄锥形束CT(CBCT),头颅定位侧位片,Tc99m_MDP颌骨计算机体层扫描(SPECT)检查,着重测量关节间隙的改变。结果:术前患侧和健侧比较关节间隙(包括前间隙、上间隙及后间隙)无统计学差异,手术后及正畸后各关节间隙手术侧与非手术侧差异有统计学意义。结论:髁突高位切除术联合术后正确的正畸治疗可以有效改善患者由于髁突肥大导致的颜面及错牙合畸形以及由此引发的颞下颌关节障碍,正畸治疗后髁突回到关节窝正常位置,患侧髁突改建,稳定性较好。

关键词: 髁突肥大, 手术治疗, 正畸治疗, 关节间隙, 种植钉

Abstract: Objective: To evaluate the influence of orthodontic treatment on temporomandibular joint after surgery of condylar hyperplasia (CH) , and to explore the stability of TMJ after surgery. Methords: Twenty patients (8 males and 12 females), aged from 17 to 34 years with an average age of 21.2 years and diagnosed as condylar hyperplasia, were selected after condylectomy high site. Straightwire appliance or invisible appliance was used for the orthodontic treatment. Mini-implants were used to intrude upper posteriors on the affected side. The function of TMJ before surgery, after surgery, and after orthodontic treatment was compared. CBCT, cephalometric film, and Tc99m_MDP SPECT were used to measure the change of joint space specifically. Results: Significant differences were found in TMJ space (including anterior space, posterior space, and superior space) of affected side and normal side after surgery and after orthodontic treatment, whereas no significant difference was found before surgery. Conclusion: Orthodontic treatment with condylectomy high site can improve the facial deformity and malocclusion induced by CH. TMD could also be improved. The condyle will return back to the normal condition in joint fossa after orthodontic treatment and the stability is promising.

Key words: Condylar hyperplasia, Surgery treatment, Orthodontic treatment, Joint space, Mini-implant