temporomandibular joint osteoarthrosis

颞下颌关节骨关节炎
  • 文章类型: Journal Article
    目的:观察浓缩生长因子(CGF)联合透明质酸钠(SH)治疗颞下颌关节骨关节炎(TMJOA)的疗效。
    方法:将2020年3月至2023年3月西安交通大学口腔医院经锥形束CT(CBCT)确诊的60例TMJOA患者随机分为对照组(n=30)和实验组(n=30)。实验组患者采用CGF+SH,对照组仅用SH治疗。显示颞下颌关节(TMJ)区域疼痛的视觉模拟评分(VAS)评分;Helkimo临床功能障碍指数(Di);首次就诊和2周时髁突CBCT的变化,记录治疗后3个月和6个月。收集实验组和对照组患者的CBCT数据,将三维CBCT图像序列以DICOM格式导入MimicsMedical19.0软件进行髁突重建。
    结果:2周时的VAS评分,治疗后3个月和6个月实验组明显低于对照组(P<0.05),实验组疼痛明显缓解。实验组Di明显低于对照组(P<0.05),TMJ的临床功能得到改善。治疗后,实验组CBCT评分明显低于对照组(P<0.05),髁突骨皮质明显修复。通过三维重建对髁状突骨皮质的观察显示与CBCT获得的结果相同。
    结论:CGF联合SH治疗TMJOA有效,可改善肌肉疼痛,TMJ疼痛,TMJ功能受损,活动范围受损,下颌骨运动疼痛,促进骨修复。
    ChiCTR2400082712。
    2024年4月5日。
    OBJECTIVE: To investigate the effect of concentrated growth factor (CGF) combined with sodium hyaluronate (SH) on temporomandibular joint osteoarthritis (TMJOA).
    METHODS: Sixty patients with TMJOA who were diagnosed by cone-beam computed tomography (CBCT) between March 2020 and March 2023 at the Stomatological Hospital of Xi\'an Jiaotong University were randomly divided into a control group (n = 30) and an experimental group (n = 30). The patients in the experimental group were treated with CGF + SH, and those in the control group were treated with SH only. The visual analogue scale (VAS) score indicating pain in the temporomandibular joint (TMJ) area; the Helkimo Clinical Dysfunction Index (Di); and changes in condylar CBCT at the first visit and 2 weeks, 3 months and 6 months after treatment were recorded. The CBCT data of the patients in the experimental and control groups were collected, and the three-dimensional CBCT image sequences were imported into Mimics Medical 19.0 software in DICOM format for condylar reconstruction.
    RESULTS: The VAS scores at 2 weeks, 3 months and 6 months after treatment were significantly lower in the experimental group than in the control group (P < 0.05), and the pain in the experimental group was significantly relieved. The Di was significantly lower in the experimental group than in the control group (P < 0.05), and the clinical function of the TMJ improved. After treatment, the CBCT score was significantly lower in the experimental group than in the control group (P < 0.05), and the condylar bone cortex was obviously repaired. Observation of the condylar bone cortex by three-dimensional reconstruction showed the same results as those obtained by CBCT.
    CONCLUSIONS: CGF combined with SH is effective in the treatment of TMJOA and can improve muscle pain, TMJ pain, Impaired TMJ function, Impaired range of movement, Pain on movement of the mandible and promote bone repair.
    UNASSIGNED: ChiCTR2400082712.
    UNASSIGNED: April 5, 2024.
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  • 文章类型: Journal Article
    OBJECTIVE: The aim of this study was to compare the anterior and posterior occlusal plane characteristics of patients with different temporomandibular joint osseous statuses.
    METHODS: A total of 306 patients with initial cone beam CT (CBCT) and cephalograms were included. They were divided into three groups on the basis of their temporomandibular joint osseous status: bilateral normal (BN) group, indeterminate for osteoarthrosis (I) group, and osteoarthrosis (OA) group. The anterior and posterior occlusal planes (AOP and POP) of the different groups were compared. Then, the regression equation was established after adjusting for confounding factors, and a correlation analysis between the occlusion planes and other parameters was performed.
    RESULTS: SNA, SNB, FMA, SN-MP, Ar-Go, and S-Go were correlated with the occlusal planes. Relative to the BN and I groups, the FH-OP of the OA group increased by 1.67° on the average, FH-POP increased by 1.42° on the average, and FH-AOP increased by 2.05° on the average.
    CONCLUSIONS: The occlusal planes were steeper in the patients with temporomandibular osteoarthrosis than in the patients without it, and the mandible rotated downward and backward. The height of the mandibular ramus, the mandibular body length, and the posterior face height were small. In clinical practice, attention should be given to the potential risk of temporomandibular joint osteoarthrosis in such patients. In addition, SNB, FMA, SN-MP, Ar-Go, S-Go, and occlusal planes had moderate correlations.
    目的: 比较不同颞下颌关节骨质情况患者的前后 平面等指标。方法: 纳入306例患者的初诊锥形束CT(CBCT)和头颅侧位片,根据关节骨质情况分为3组:双侧正常组、骨关节病(OA)组、疑似OA组。比较3组患者前牙 平面(AOP)、后牙 平面(POP)等指标,去除混杂因素影响后建立回归方程,并进行 平面与其余指标的相关性分析。结果: SNA、SNB、FMA、SN-MP、Ar-Go、S-Go与 平面指标具有相关性;与双侧正常及疑似OA组相比,OA组患者FH-OP平均增加1.67°;FH-POP平均增加1.42°;FH-AOP平均增加2.05°。结论: OA患者的 平面较陡,下颌骨向下后旋转,下颌升支、下颌体部、后面高较小,临床上对于这类患者应注意颞下颌OA的潜在危险;SNB、FMA、SN-MP、Ar-Go、S-Go与 平面指标有较好相关性。.
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  • 文章类型: Observational Study
    目的:研究在II类超发散性TMJ骨关节病(TMJOA)患者中,垂直对照辅助正畸迷彩治疗与正颌手术之间,髁突的轮廓变化和稳定性的差异。
    方法:这项研究包括27例II类超发散TMJOA患者(54个髁),他们接受正畸伪装治疗(13例)或正颌手术(14例)治疗前(T1)和治疗后1年(T2)进行锥形束计算机断层扫描(CBCT)扫描。使用独立样本t检验和配对t检验进行头影和TMJ测量分析以评估从T1到T2的轮廓和髁的变化。还进行了三维(3D)偏差分析,以评估从T1到T2的髁的稳定性。
    结果:两组均显示从T1到T2的显著改善。手术组的Z角和ANB角的变更年夜于正畸组。髁突宽度,长度,正畸组治疗后身高保持稳定(P>.05),虽然它们减少了0.67±0.85毫米,1.14±1.10mm,和1.07±1.34毫米,分别,手术组(P<0.05)。Superior,后部,中间,正畸组外侧关节间隙明显减少(P<0.05)。3D偏差直观地显示,正畸组髁突骨比手术组更稳定。
    结论:对于患有严重TMJOA的II类过度发散患者,垂直控制正畸迷彩治疗可有效维持髁突的稳定性,同时显著改善髁突的轮廓。手术治疗产生更好的轮廓,但可能增加髁再吸收的风险。
    To investigate the differences in profile changes and stability of the condyles between orthodontic camouflage treatment assisted by vertical control and that accomplished via orthognathic surgery in Class II hyperdivergent patients with TMJ osteoarthrosis (TMJOA).
    This study included 27 Class II hyperdivergent TMJOA patients (54 condyles) who received orthodontic camouflage treatment (13 patients) or orthognathic surgery (14 patients) Cone-beam computerized tomography (CBCT) scans were taken before treatment (T1) and 1 year after treatment (T2). Cephalometric and TMJ measurement analyses were conducted to evaluate the change in profile and condyles from T1 to T2 using independent samples t-test and paired t-test. Three-dimensional (3D) deviation analysis was also performed to evaluate the stability of condyles from T1 to T2.
    Both groups showed significant profile improvement from T1 to T2. The changes in Z angle and ANB angle were larger in the surgical group than in the orthodontic group. Condylar width, length, and height remained stable after treatment in the orthodontic group (P > .05), while they reduced by 0.67 ± 0.85 mm, 1.14 ± 1.10 mm, and 1.07 ± 1.34 mm, respectively, in the surgical group (P < .05). Superior, posterior, medial, and lateral joint spaces were significantly reduced in the orthodontic group (P < .05). 3D deviations intuitively showed that condylar bone in the orthodontic group was more stable than that in the surgical group.
    For Class II hyperdivergent patients with severe TMJOA, orthodontic camouflage treatment with vertical control can effectively maintain the stability of condyles while significantly improving the profile. Surgical treatment yields a better profile but may increase the risk of condyle resorption.
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  • 文章类型: Journal Article
    目的:评估有和没有颞下颌关节骨关节病(TMJOA)的男性牙骨形态的差异。
    方法:这项横断面研究招募了三百七十一名寻求正畸治疗的男性参与者。使用锥形束计算机断层扫描(CBCT)评估每个参与者的骨状态,并将其分类为正常(N=104),对于TMJOA(N=110)不确定,和TMJOA(N=157)组。使用头颅图评估牙骨骼特征。根据年龄和骨骼模式进行分层分析。进行描述性统计和单向方差分析以调查各组之间的牙骨骼差异。P<0.05被认为具有统计学意义。
    结果:后颅底长度的差异,FMA,MP-OP,前面部高度,关节角,拉姆高度,和L1-MP有统计学意义。按年龄分层后,FMA的差异,上下颌角,后面部高度,面部身高比率,角,成人下颌骨体长有统计学意义。青少年除关节角外无统计学差异。按骨骼模式分层后,统计学差异主要在骨骼II类成人中很明显.
    结论:患有TMJOA的男性表现为向后定位和向后旋转的下颌骨,尤其是骨骼II类成人。男性的颅面形态受TMJOA的影响较小。TMJOA和颅面形态之间的关联在不同年龄段和骨骼模式之间也有所不同。需要进行前瞻性研究以阐明男性TMJOA与颅面形态之间的因果关系。
    OBJECTIVE: The objective of the study was to assess the differences in dentoskeletal morphology in males with and without temporomandibular joint osteoarthrosis (TMJOA).
    METHODS: Three hundred seventy-one male participants seeking orthodontic treatment were enrolled in this cross-sectional study. Each participant\'s osseous status was evaluated using cone-beam computed tomography (CBCT) and classified into normal (N = 104), indeterminate for TMJOA (N = 110) and TMJOA (N = 157) groups. The dentoskeletal characteristics were evaluated using cephalograms. Stratified analysis was performed based on age and skeletal pattern. Descriptive statistics and one-way analysis of variance were performed to investigate dentoskeletal differences among groups. P < .05 was considered statistically significant.
    RESULTS: The differences in posterior cranial base length, FMA, MP-OP, anterior facial height, articular angle, ramus height and L1-MP were statistically significant. After stratification by age, the differences in FMA, maxillomandibular angle, posterior facial height, facial height ratio, gonial angle and mandibular body length were statistically significant in adults. No statistical difference except for articular angle was observed in adolescents. After stratification by skeletal pattern, statistical differences were mainly apparent in skeletal Class II adults.
    CONCLUSIONS: Males with TMJOA showed a posteriorly positioned and backward-rotated mandible, especially in skeletal Class II adults. Compared with women, the craniofacial morphology of men is less affected by TMJOA. The association between TMJOA and craniofacial morphology also varied across different age groups and skeletal patterns. Prospective studies are required to clarify the cause-effect relationship between TMJOA and craniofacial morphology in males.
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