周境;刘怡;

• 1:北京大学口腔医学院·口腔医院正畸科国家口腔疾病临床医学研究中心口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室

摘要(Abstract)：

目的:探讨不同垂直骨面型骨性Ⅱ类青少年女性颞下颌关节形态和位置特征。方法:纳入北京大学口腔医院正畸科初诊拍摄大视野锥形束CT(cone-beam CT,CBCT)的11～14岁女性80例,按照上牙槽座点-鼻根点-下牙槽座点角(subspinale-nasion-supramental angle,ANB)和下颌平面角(Frankfort horizontal plane-gonion-gnathion angle,FH-Go Gn)大小分为骨性Ⅰ类均角组(组1,0°≤ANB<4°,22°≤FH-Go Gn≤32°),骨性Ⅱ类低角组(组2,ANB≥4°,FH-Go Gn<22°)、均角组(组3,ANB≥4°,22°≤FH-Go Gn≤32°)和高角组(组4,ANB≥4°,FH-Go Gn>32°),每组20例,导入Dolphin软件进行头影测量和关节形态、位置测量。分别使用配对t检验、方差分析和卡方检验比较双侧关节对称性和关节形态及位置的组间差异,采用相关性分析探索骨性Ⅱ类人群头影测量值与关节测量项目间相关关系。结果:(1)关节对称性分析中,四组都存在少量差异有统计学意义的测量项目;组4双侧髁突位置不对称的样本量最多(65%),其余三组比例相近,但差异无统计学意义。(2)对比组1和组3,关节形态学测量差异无统计学意义;髁突位置组1以前位和中位为主,组3居于后位者明显多于组1(χ~2=6.936,P<0.05)。(3)在组2、3、4中,组2关节窝深度最深(H_(2&4)=10.517,P=0.002),关节上间隙(LSD-t_(2&3)=3.408,LSD-t_(2&4)=5.369,P<0.001)、外间隙(LSD-t_(2&3)=2.767,LSD-t_(2&4)=3.350,P=0.001)最大;组4髁突长轴径最小(H_(2&4)=13.374,P<0.001),关节窝垂直距最大(LSD-t_(2&4)=4.561,P<0.001;LSD-t_(3&4)=2.713,P=0.007),关节内间隙(LSD-t_(2&4)=-4.083,P<0.001)、中间隙(LSD-t_(2&4)=-4.201,P<0.001)最小。从组2、组3到组4,后位髁突所占比例逐渐升高。相关性分析显示,ANB与关节前间隙呈显著正相关(r=0.270,P=0.037),与髁突长轴角呈显著负相关(r=-0.296,P=0.022);FH-Go Gn与关节上间隙(r=-0.488,P<0.001)、后间隙(r=-0.272,P=0.035)、内间隙(r=-0.390,P=0.002)、中间隙(r=-0.425,P=0.001)、外间隙(r=-0.331,P=0.010)、关节窝深度(r=-0.363,P=0.004)、关节结节后斜面倾斜度(r=-0.259,P=0.046)、髁突长轴径(r=-0.327,P=0.011)呈显著负相关,与关节窝垂直距呈显著正相关(r=0.370,P=0.004)。结论:Ⅱ类矢状骨面型的关节特征主要体现在髁突位置而非关节形态。Ⅱ类不同垂直骨面型关节形态及位置的差异更多地体现在关节间隙以及髁突和关节窝位置,从低角到高角关节窝位置逐渐增高,髁突后位比例逐渐增大。Ⅱ类高角的关节窝位置最高,髁突后位比例最大,关节间隙最小,关节窝深度最浅,髁突长轴径最短,关节不稳定因素最多,在进行正畸治疗时要尤其注意。

关键词(KeyWords)： 颞下颌关节;锥形束计算机体层摄影术;骨性Ⅱ类;垂直骨面型;青少年

Abstract:

Keywords:

基金项目(Foundation): 宁夏回族自治区重点研发计划重点项目课题(2018BEG02012)~~

作者(Author): 周境;刘怡;

Email:

DOI: 10.19723/j.issn.1671-167X.2021.01.017

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