目的 对广东地区不同人群的下颌骨及髁突解剖参数进行三维分析。 方法 选取就诊于南方医科大学口腔医院的患者265名，利用CBCT分别测量男性和女性的髁突长度、髁突高度、下颌升支高度、下颌体高度以及下颌神经进入下颌升支的位置。 结果 所有患者髁突的平均长度（内极-外极）二维测量为19.2 mm、三维测量为20.3 mm，男性比女性长3.6 mm，两者之间无统计学差异。下颌骨高度、髁突高度和下颌升支高度分别为59.6 mm，22.8 mm和38.3 mm，其中下颌骨高度男性比女性长6.4 mm，两性之间有统计学差异。下颌升支的宽度、下颌小舌到升支前缘的距离和下颌小舌到升支后缘的距离分别为：29.4 mm，14.8 mm及14.6 mm，男女之间均无统计学差异。 结论 CBCT测量颞下颌关节有着更显著的准确性，本实验结果丰富了中国人群下颌骨解剖数据，有助于开发适合广东地区的人工颞下颌关节。
【关键词】 下颌骨； 髁突； CBCT； 人工颞下颌关节
关键词：
下颌骨; ; ; 髁突; ; ; CBCT; ; ; 人工颞下颌关节
Objective To evaluate various anatomic parameters of mandible and temporomandibular joint in Guangdong population. Methods A total of 265 patients admitted to Stomatology Hospital, Southern Medical University were selected to measure the condyle length , the condyle height, the height of mandibular ascending branch, and the position of the inferior mandibular nerve entering mandibular ascending branch in male and female respectively by using CBCT. Results In all patients, the mean length of the condyle was 19.2 mm in two-dimension and 20.3 mm in three-dimension, and the condyle length in males was showed longer than female by 3.6 mm. Mandibular height, condylar height, and the height of mandibular ascending branch was 59.6 mm, 22.8 mm, and 38.3 mm, respectively. Males showed longer than female in mandibular height by 6.4 mm, with statistical differences between in male and female. The width of mandible ascending branch, the distance from the uvula to the anterior ridge of the ascending ramus and the distance from the uvula to the posterior border of the ascending ramus were 29.4 mm, 14.8 mm, and 14.6 mm, respectively, with no statistical difference between male and female. Conclusions CBCT has more significant accuracy in the measurement of temporomandibular joint. The results of this experiment enrich the mandibular anatomical data of Chinese population and contribute in the development of artificial temporomandibular joint which is suitable for Guangdong population.
[1] Abdallah R, Courtright P. Temporomandibular Joint[M]//Pain. Springer, Cham, 2019: 721-723.
[2] 张清彬,管红兵. 颞下颌关节紊乱病的“梯度序列治疗”[J]. 口腔疾病防治, 2020, 28(1): 11-15. DOI: 10.12016/j.issn.2096-1456.2020.01.002.
[3] 张志光, 刘文静. 颞下颌关节紊乱病与关节内压[J]. 口腔疾病防治, 2018, 26(2): 69-74. DOI: 10.12016/j.issn.2096-1456.2018.02.001.
[4] Yoda T, Ogi N, Yoshitake H, et al. Clinical guidelines for total temporomandibular joint replacement[J]. Jpn Dent Sci Rev, 2020, 56(1): 77-83. DOI: 10.1016/j.jdsr.2020.03.001.
[5] Gupta RJ, Schendel SA, Wolford L. Concomitant custom-fitted temporomandibular joint reconstruction and orthognathic surgery[M]// Contemporary Management of Temporomandibular Disorders. 2019: 233-285.
[6] Hilgers ML, Scarfe WC, Scheetz JP, et al. Accuracy of linear temporomandibular joint measurements with cone beam computed tomography and digital cephalometric radiography[J]. Am J Orthod Dentofacial Orthop, 2005, 128(6): 803-811. DOI: 10.1016/j.ajodo.2005.08.034.
[7] Laster WS, Ludlow JB, Bailey LJ, et al. Accuracy of measurements of mandibular anatomy and prediction of asymmetry in panoramic radiographic images[J]. Dentomaxillofac Radiol, 2005, 34(6): 343-349. DOI: 10.1259/dmfr/28020783.
[8] Różyło-Kalinowska I. Cone Beam Computed Tomography (CBCT) in TMJ Imaging[M]// Imaging of the Temporomandibular Joint. Springer, Cham, 2019: 125-131.
[9] Ocak M, Sargon MF, Orhan K, et al. Evaluation of the anatomical measurements of the temporomandibular joint by cone-beam computed tomography[J]. Folia Morphol (Warsz), 2019, 78(1): 174-181. DOI: 10.5603/FM.a2018.0060.
[10] Ishibashi H, Takenoshita Y, Ishibashi K, et al. Age-related changes in the human mandibular condyle: a morphologic, radiologic, and histologic study[J]. J Oral Maxillofac Surg 1995, 53(9): 1016-1023. DOI: 10.1016/0278-2391(95)90117-5.
[11]Coombs MC, Bonthius DJ, Nie XJ, et al. Effect of measurement technique on TMJ mandibular condyle and articular disc morphometry: CBCT, MRI and physical measurements[J]. J Oral Maxillofac Surg, 2019, 77(1): 42-53. DOI: 10.1016/j.joms.2018.06.175.
[12]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. DOI:10.1097/MD.0000000000002897.
[13]Park SH, Yu HS, Kim KD, et al. A proposal for a new analysis of craniofacial morphology by 3-dimensional computed tomography[J]. Am J Orthod Dentofacial Orthop, 2006, 129(5): e23-e34. DOI: 10.1016/j.ajodo.2005.11.032.
[14]Zhou C, Jeon TH, Jun SH, et al. Evaluation of mandibular lingula and foramen location using 3-dimensional mandible models reconstructed by cone-beam computed tomography[J]. Maxillofac Plast Reconstr Surg, 2017, 39(1): 30-31. DOI: 10.1186/s40902-017-0128-y.
[15]Jang HY, Han SJ. Measurement of mandibular lingula location using cone-beam computed tomography and internal oblique ridge-guided inferior alveolar nerve block[J]. Korean Assoc Oral Maxillofac Surg, 2019, 45(3): 158-166. DOI: 10.5125/jkaoms.2019.45.3.158.
[16]Kurita H, Ohtsuka A, Kobayashi H, et al. Alteration of the horizontal mandibular condyle size associated with temporomandibular joint internal derangement in adult females[J]. Dentomaxillofac Radiol, 2002, 31(6): 373-378. DOI: 10.1038/sj.dmfr.4600727.
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