摘要
目的 :探讨颞颌关节紊乱综合征患者颞颌关节骨质改变特征及意义。方法 :拍摄 792例颞颌关节紊乱综合征患者 (男 330例 ,女 46 2例 )的双侧颞颌关节X线片。其中拍摄薛氏位片者 2 10例 42 0侧 ,拍侧位体层X线片者 2 2 3例 44 6侧 ;薛氏位片和侧位体层X线片均拍摄者 35 9例 718侧。X线诊断结果由门诊医生和放射科医生共同阅片得出。结果 :①骨质改变检出率 :1138侧薛氏位片显示髁突 (该片颞骨关节面观察不满意 )有骨质改变者 2 88侧。116 4侧侧位体层摄影片显示髁突骨质改变者 82侧 ,颞骨关节面骨质改变者 74侧。②骨质改变类型 :髁突的吸收性改变与增生性改变所占比例无明显差异 ,颞骨关节面的骨质改变以增生性为主。③髁突前斜面、关节结节顶、关节结节后斜面为骨质改变的好发部位。结论 :颞颌关节X线片骨质改变特征可能与牙尖交错位附近力学变化特征及各部位随功能需要发生改建的特性有关 ;两种投照方法的选择 ,尚待进一步研究。
Objective: The characteristics of temporomandibular joint (TMJ) bone changes showed by X ray films in patients diagnosed as Temporomandibular Joint Disorders (TMJDs) were investigated. Methods: X ray films of 792 TMJDs patients who were diagnosised as TMJDs in our hospital from 1988 to 1995 were studied. Among them, 330 cases were male and 462 cases were female. Their ages ranged from 11 to 66 years old, averaged 27.4 years old. Bilateral TMJ, 1584 sides in all, were checked by X ray. Among them, 210 cases (420 sides) were examined with transcranial projective technique, 223 cases (446 sides) with tomogram, and 359 cases (718 sides) with both tomogram and transcranial projective techniques, Clinician observed and discussed the films together with the radiographer, and then the final radio diagnosis was got. Results: ①288 (25 31%) out of 1138 condyles examined with transcranial projective technique (temporal articular surface can not be observed accurately in this kind of films) and 82 (7 04%) out of 1164 condyles, 74 (6 36%) out of 1164 temporal articular surfaces checked with tomogram showed osseous changes. With analyzing on 718 sides of 356 cases checked with both methods, it was found that transcranial projective technique was more sensitive to TMJ osseous changes (P<0 01). ②The types of osseous changes: within the osseous changes of condyles showed in transcranial projection, 126 sides (43 75%) were mainly hyperplasia, and 140 sides showed absorptive changes. Moreover, both kinds of alterations appeared in 22 sides (7 64%). Among the condyles with osseous changes showed in tomogram, 28 sides were mainly hyperplasia and 54 sides showed absorptive changes, while two kinds of changes were not found in the same tomogram. But for temporal articular surface, 34 sides showed hyperplasia and 6 sides absorptive changes as their chief alterations. And the other 34 sides showed the two kinds of changes. Hyperplasia appeared more frequently in temporal articular surface than in condyles showed in tomogram (P<0 01). ③It was found that the osseous alterations were liable to occur in anterior condyle slope (88 19% in the films checked with transcranial projective technique, 81 71% in the films checked with tomography), the top (72 97% in the films checked with tomography) and the posterior slopes (71 62% in the films checked with tomography) of the articular eminence. Conclusion: Being considered the characteristics of the osseous changes, the abnormal mechan ics around ICP and physiological or pathological remodeling principles of different parts of TMJ might be explained. Further researches on the selection of the two examinational methods of TMJ were suggested.
出处
《华西口腔医学杂志》
CAS
CSCD
北大核心
2000年第2期109-111,共3页
West China Journal of Stomatology
关键词
颞颌关节紊乱综合征
X线片
骨质改变
temporomandibular joint disorders X-ray film osseous changes
