采用CT三维图像测量国人颞下颌关节假体固定区域形态学参数及其临床意义
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摘要
目的:采用计算机断层扫描(CT)重建技术测量国人颞下颌关节(TMJ),阐明国人TMJ假体的安全固定区域。方法:对100例成年人头部进行CT扫描和三维重建,测量双侧TMJ假体固定区域中颧弓部分的宽度、厚度和角度h1、h2、h3、h4、d1、d2、d3、d4、ab、bc、cd、ad、α和β;关节窝部分的宽度和高度BD和h;下颌支部分的宽度、厚度和角度S、h5、h6、h7、l1、l2、l3、l4、l5、m1、m2、m3、m4、m5和γ。所有测量指标依据方向分为左右侧2组,采用SPSS 19.0软件比较左右侧2组测量指标的差异。结果:测得TMJ颧弓、关节窝和下颌支假体固定区域部分的测量指标h1、h2、h3、h4、d1、d2、d3、d4、ab、bc、cd、ad、α、β、BD、h、S、h5、h6、h7、l1、l2、l3、l4、l5、m1、m2、m3、m4、m5和γ的数据,左右侧2组各指标测量值比较差异均无统计学意义(P>0.05);颧弓部分h2的宽度大于h3(P=0.048),d3的宽度大于d4(P<0.01)。结论:采用CT三维图像得到了国人TMJ假体安全固定区域的测量数据。
Objective:To measure the morphologic data of Chinese temporomandibular joint(TMJ)with computed tomography(CT)reconstruction technology,and to clarify the safe area for the fixation of Chinese temporomandibular joint prosthesis.Methods:A total of 100 adult skulls were scanned by CT and reconstructed.The width,thickness and angle h1,h2,h3,h4,d1,d2,d3,d4,ab,bc,cd,ad,αandβof zygomatic arch,the width and height BD and h of articular fossa and the width,thickness and angle S,h5,h6,h7,l1,l2,l3,l4,l5,m1,m2,m3,m4,m5andγof mandible in the fixed area of the TMJ prosthesis were measured;all the measurement indexes were divided into left and right groups by direction,and SPSS 19.0software was used for the comparion of the measurement between left and right groups.Results:There were no statistical differences in the measurement index values of h1,h2,h3,h4,d1,d2,d3,d4,ab,bc,cd,ad,α,β,BD,h,S,h5,h6,h7,l1,l2,l3,l4,l5,m1,m2,m3,m4,m5 andγin zygomatic arch,articular fossa and mandible in the fixed area of the TMJ prosthesis between left and right groups(P>0.05);the width of h2 was longer than that of h3 in zygomatic arch(P =0.048);the thickness of d3 was thicker than that of d4(P <0.01).Conclusion:The measurement data of TMJ fixed area is obtained with three-dimensional CT images.
Objective:To measure the morphologic data of Chinese temporomandibular joint(TMJ)with computed tomography(CT)reconstruction technology,and to clarify the safe area for the fixation of Chinese temporomandibular joint prosthesis.Methods:A total of 100 adult skulls were scanned by CT and reconstructed.The width,thickness and angle h1,h2,h3,h4,d1,d2,d3,d4,ab,bc,cd,ad,αandβof zygomatic arch,the width and height BD and h of articular fossa and the width,thickness and angle S,h5,h6,h7,l1,l2,l3,l4,l5,m1,m2,m3,m4,m5andγof mandible in the fixed area of the TMJ prosthesis were measured;all the measurement indexes were divided into left and right groups by direction,and SPSS 19.0software was used for the comparion of the measurement between left and right groups.Results:There were no statistical differences in the measurement index values of h1,h2,h3,h4,d1,d2,d3,d4,ab,bc,cd,ad,α,β,BD,h,S,h5,h6,h7,l1,l2,l3,l4,l5,m1,m2,m3,m4,m5 andγin zygomatic arch,articular fossa and mandible in the fixed area of the TMJ prosthesis between left and right groups(P>0.05);the width of h2 was longer than that of h3 in zygomatic arch(P =0.048);the thickness of d3 was thicker than that of d4(P <0.01).Conclusion:The measurement data of TMJ fixed area is obtained with three-dimensional CT images.
引文
[1]何冬梅,胡逸晖,杨驰,等.人工颞下颌关节治疗关节强直的效果分析[J].中国口腔颌面外科杂志,2017,15(1):20-25.
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[10]么学东,范松青,安高,等.颞下颌关节骨性结构的测量与分析[J].实用口腔医学杂志,2011,27(6):801-804.
[11]曹均凯,王照五,刘洪臣,等.54例正常人双侧颞下颌关节CBCT测量值分析[J].口腔颌面修复学杂志,2008,9(4):291-294.
[12]Swennen GR,Schutyser F.Three-dimensional cephalometry:spiral multi-slice vs cone-beam computed tomography[J].Am J Orthod Dentofacial Orthop,2006,130(3):410-416.
[13]于镇滔,孙嘉良,李书轩,等.横窦与颅外骨性标志线位置关系的CT重建图像及其临床意义[J].吉林大学学报:医学版,2015,42(3):591-594,640.
[14]Alhassani AA,AlGhamdi AS.Inferior alveolar nerve injury in implant dentistry:diagnosis,causes,prevention,and management[J].J Oral Implantol,2010,36(5):401-407.
[15]叶周熹,杨驰.下颌阻生智牙拔除术中下牙槽神经血管束损伤风险因素分析[J].中国口腔颌面外科杂志,2016,14(1):51-56.
[16]滕薇,张克,常全胜.64例口腔颌面外科术后神经损伤护理体会[J].中国实用神经疾病杂志,2016,19(21):124-125.
[17]高翔,王忠厚,赵云刚,等.种植体支持的磁性附着体下颌覆盖义齿的三维有限元分析[J].中国老年学杂志,2016,36(11):2731-2733.
[2]张露珠,常雨丝,何冬梅.颞下颌关节骨性结构的测量研究[J].中国实用口腔科杂志,2016,9(9):566-569.
[3]Sidebottom AJ,Gruber E.One-year prospective outcome analysis and complications following total replacement of the temporomandibular joint with the TMJ Concepts system[J].Br J Oral Maxillofac Surg,2013,51(7):620-624.
[4]Westermark A.Total reconstruction of the temporomandibular joint.Up to 8 years of follow-up of patients treated with Biomet○Rtotal joint prostheses[J].Int J Oral Maxillofac Surg,2010,39(10):951-955.
[5]焦子先,郑吉驷,刘欢,等.成人颅下颌骨解剖测量分析[J].中国口腔颌面外科杂志,2015,13(2):151-154.
[6]白果,何冬梅,杨驰,等.数字化导板在标准型人工颞下颌关节置换术中的应用[J].中国口腔颌面外科杂志,2015,13(1):21-27.
[7]Zhang LZ,Meng SS,He DM,et al.Three-Dimensional measurement and cluster analysis for determining the size ranges of Chinese temporomandibular joint replacement prosthesis[J].Medicine(Baltimore),2016,95(8):e2897.
[8]Wolford LM,Mercuri LG,Schneiderman ED,et al.Twenty-year follow-up study on a patient-fitted temporomandibular joint prosthesis:the Techmedica/TMJ Concepts device[J].J Oral Maxillofac Surg,2015,73(5):952-960.
[9]刘欢,张晓虎,杨驰,等.改良人工全颞下颌关节置换术及效果评价[J].中国口腔颌面外科杂志,2014,12(4):318-322.
[10]么学东,范松青,安高,等.颞下颌关节骨性结构的测量与分析[J].实用口腔医学杂志,2011,27(6):801-804.
[11]曹均凯,王照五,刘洪臣,等.54例正常人双侧颞下颌关节CBCT测量值分析[J].口腔颌面修复学杂志,2008,9(4):291-294.
[12]Swennen GR,Schutyser F.Three-dimensional cephalometry:spiral multi-slice vs cone-beam computed tomography[J].Am J Orthod Dentofacial Orthop,2006,130(3):410-416.
[13]于镇滔,孙嘉良,李书轩,等.横窦与颅外骨性标志线位置关系的CT重建图像及其临床意义[J].吉林大学学报:医学版,2015,42(3):591-594,640.
[14]Alhassani AA,AlGhamdi AS.Inferior alveolar nerve injury in implant dentistry:diagnosis,causes,prevention,and management[J].J Oral Implantol,2010,36(5):401-407.
[15]叶周熹,杨驰.下颌阻生智牙拔除术中下牙槽神经血管束损伤风险因素分析[J].中国口腔颌面外科杂志,2016,14(1):51-56.
[16]滕薇,张克,常全胜.64例口腔颌面外科术后神经损伤护理体会[J].中国实用神经疾病杂志,2016,19(21):124-125.
[17]高翔,王忠厚,赵云刚,等.种植体支持的磁性附着体下颌覆盖义齿的三维有限元分析[J].中国老年学杂志,2016,36(11):2731-2733.