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锥形束CT研究正畸治疗前后的单侧后牙正锁合的髁突变化
Cone beam CT evaluation of unilateral scissors-bite posterior molar patients with orthodontic treatment: condylar morphology and location
目的 应用锥形束CT(CBCT)研究分析单侧后牙正锁合患者的双侧髁突形态及其在关节窝内位置的差异，以及正锁合解除后，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 选择单侧后牙正锁合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），实验组正锁合侧关节窝深度及髁突高度高于非锁合侧，差异具有统计学意义（t=13.271,t=15.278, P＜0.01）。正畸治疗正锁合并稳定保持3个月后，实验组正锁合侧关节前间隙、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。实验组非锁合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 单侧后牙正锁合患者双侧髁突形态及其在关节窝内的位置存在差异，矫治正锁合并稳定保持3个月后，锁合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 analyse the condylar morphology and location of the scissors-bite patients by cone beam computed tomography(CBCT),and investigate the remodeling changes of condylar after scissors-bite side solved. Methods Twenty cases between 18-28 years old with unilateral scissors-bite were selected as the experimental group and 25 cases between 18-30 years old with ClassⅠmalocclusion were selected as the control group.All the forty-five subjects had no orthodontic treatment before. Both groups had three-dimensional CBCT imaging with examvision system. Different measurement points and lines of the condylar morphology and location, and 7 measured values were statisticallly analyzed. Results None statistically significant was observed in control group（P＞0.05）, The mandibular fossa depth and the condylar height showed statistically significant differences between the scissors-bite and non-scissors-bite sides（t=13.271,t=15.278, P＜0.01）. After treatment and kept stable for 3 month, statistical significances of anterior joint space and posterior joint space were found as compared with before（t=5.524,t=-5.119,P＜0.01）. Conclusion There are differences in condylar morphology and location of unilateral scissors-bite posterior molar patients, after -bite solved for 3 month. There is a tendency to more downward and forward positions in fossa, and there are no special characteristic changes in the condylar morphology observed in this study.
正锁合 / 髁突 / 锥形束CT（CBCT） / 人
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