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[1]王琤,许丽凤,周冰.51例功能性颞下颌关节紊乱病患者的影像学观察与分析[J].医学研究与战创伤救治(原医学研究生学报),2022,24(1):27-31.[doi:10.3969/j.issn.1672-271X.2022.01.006]
　WANG Cheng,XU Li-feng,ZHOU Bing.Imaging observation and analysis of 51 patients with temporomandibular joint disorder[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(1):27-31.[doi:10.3969/j.issn.1672-271X.2022.01.006]
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51例功能性颞下颌关节紊乱病患者的影像学观察与分析()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年1期
页码:
27-31
栏目:
临床研究
出版日期:
2022-02-20

文章信息/Info

Title:
Imaging observation and analysis of 51 patients with temporomandibular joint disorder
作者:
王琤; 许丽凤; 周冰
作者单位：350025福州,解放军联勤保障部队第九○○医院口腔科(王琤、周冰)，影像科（许丽凤）
Author(s):
WANG Cheng; XU Li-feng; ZHOU Bing
(1.Department of Stomatology, 2.Department of Imaging, the 900th Hospital of the Joint Logistics Support Force，PLA，Fuzhou 350025, Fujian, China)
关键词:
颞下颌关节紊乱病; 颞下颌关节结构内紊乱; 锥形束CT; 核磁共振成像
Keywords:
temporomandibular joint disorder;  temporomandibular joint intend derangement;  cone beam Ct;  magnetic resonance imaging
分类号:
R782.63
DOI:
10.3969/j.issn.1672-271X.2022.01.006
文献标志码:
A
摘要:
目的利用锥形束CT（CBCT）与核磁共振成像（MRI）技术观察与分析颞下颌关节紊乱病（TMD）患者的颞下颌关节盘突结构改变与其临床症状间的关系，为TMD患者的临床诊断和治疗提供参考。方法收集2021年1月至4月在解放军联勤保障部队第九○○医院口腔科就诊的TMD患者56例，分为单一症状组（疼痛、弹响、下颌功能障碍）12例、复合症状组（疼痛+弹响、疼痛+下颌功能障碍、弹响+下颌功能障碍、疼痛+弹响+下颌功能障碍）39例；正常对照组5例为无TMD临床症状因其他口腔治疗而就诊的患者。所有受试者经CBCT和MRI检查后，测量所有受试者左右侧颞下颌关节间隙、关节盘中带距离和关节盘后带角度，分析3组受试者的髁状突位置、关节盘位置的差异。结果56例受试者自身左右侧关节间隙指数、关节盘中带距离和后带角度间差异无统计学意义（P>0.05）；3组受试者间隙指数与关节盘位置差异均有统计学意义（P均<0.01）；组间多重比较显示，复合症状组间隙指数（-6.090±22.659）为3组中最低，关节盘中带距离[(4.519±3.505)mm]、关节盘后带角度[(46.330±34.277) °]为3组中最高；健康对照组间隙指数（20.200±21.831）为3组中最高，关节盘中带距离[(1.400±1.265)mm]、关节盘后带角度[(15.900±19.017) °]为3组中最低。复合症状组间隙指数、关节盘中带距离和关节盘后带角度与单一症状组、健康对照组比较差异均有统计学意义（P<0.05）。结论颞下颌关节内部结构紊乱（TMJID）与临床症状有关，CBCT结合MRI影像学检查可以较清晰准确判断TMD患者颞下颌关节结构紊乱程度，是临床TMD患者重要的诊疗技术手段。
Abstract:
ObjectiveTo analyze relationship between Internal structure of the TMJ changes and clinical symptoms of temporomandibular joint by cone-beam CT and MRI in patients with temporomandibular joint disorder (TMD), so as to provide reference information for clinical diagnosis and treatment of patients with TMD.Methods56 patients with TMD admitted to the Department of Stomatology in the 900th Hospital of the PLA Joint Logistics Support Force were collected from Jan to Apr 2021. The patients were divided into three groups: 12 cases of TMD in the single symptom group (pain, licks, Mandibular dysfunction), 39 cases of TMD in the complex symptoms group （pain+click, pain+Mandibular dysfunction, click+Mandibular dysfunction, pain+click+Mandibular dysfunction），Five healthy volunteers without clinical symptoms of TMD in the control group. After CBCT and MRI examination, the left and right temporomandibular joint space and articular disc positions of all patients were measured according to the Gkalp H’S. The condylar position and articular disc position of the 3 groups were analyzed.ResultsThere was no significant difference in left and right joint space index and articular disc position among 56 patients （P>0.05）. There was statistical significance in the measurement index of the joint space and the position of the articular disc in each term（P<0.01）. Multiple comparisons between groups showed that the joint space index in the complex symptoms group was （-6.090±22.659）, which was the lowest among the three groups. The median disc distance was [(4.519±3.505) mm]. The angle of posterior disc in the complex symptoms group was [(46.330±34.277) °], which were the highest among the three groups. The joint space index of the healthy control group was （20.200±21.831）, which was the highest among the three groups. The median disc distance was [(1.400±1.265) mm]. The angle of posterior disc in the healthy control group was [(15.900±19.017) °], which were the lowest among the three groups. Compared with the single symptom group and the healthy control group, there were significant differences in the joint space index, the median disc distance and the angle of posterior disc in the complex symptoms group (P<0.05).ConclusionTemporomandibular Joint Intend Derangement (TMJID) is correlated with clinical symptoms. CBCT combined with MR imaging examination can clearly and accurately determine the degree of TMD structure disorder in patients with TMD, which is an important diagnostic and treatment technique for clinical TMD patients.

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更新日期/Last Update: 2022-02-21