摘要
目的探究下颌后缩型成人骨性Ⅱ类错[牙合]伴高角患者矫治前后下颌垂直高度控制参数与颞下颌关节(TMJ)形态学参数变化的相关性。方法选取我院2019年1月至2024年1月收治的163例成人骨性Ⅱ类错[牙合]伴高角患者。将患者锥形束CT(CBCT)影像数据导入Mimics20软件,测量下颌垂直高度控制参数[前颅底-下颌平面角(SN-MP)、后面高与前面高比值(S-Go/N-Me)及下颌真性旋转角(XiPm-SN)]、TMJ骨性形态学参数[髁突宽度(CW)、髁突长度(CL)、髁突体积(CV)、髁突表面积(CSA)、关节窝宽度(FW)、关节窝长度(FL)、关节窝深度(FD)、关节结节角(NA)、关节前间隙(AS)、关节上间隙(SS)、关节后间隙(RS)、髁突中间隙(MS)、髁突内间隙(IS)、髁突外间隙(ES)]值,分析下颌垂直向控制参数与TMJ形态学参数的相关性。结果患者矫治后SN-MP角、S-Go/N-Me及XiPm-SN角均明显减小,差异有统计意义(PP<0.05);矫治后CW、CL、CV、CSA、FW、FD、NA明显增大,IS、ES明显减小,但FL、AS、SS、RS、MS无明显变化;△_(SN-MP)角与△_(IS)、△_(ES)呈正相关(P<0.05),△_(S-Go/N-Me)与△_(CW)、△_(FW)呈负相关(P<0.05),与△_(IS)、△_(ES)呈正相关P<0.05),△_(XiPm-SN)角与△_(IS)、△_(ES)呈正相关(P<0.05)。结论矫治前后SN-MP角、S-Go/N-Me及XiPm-SN角的变化量与髁突及关节窝宽度和髁突内/外间隙的变化量有关,以此作微种植体支抗设计参考有助于下颌获得良好的高度控制,以改善成人骨性Ⅱ类错[牙合]伴高角患者侧貌。
Objective To investigate the correlation between changes of mandibular vertical height control parameters and temporomandibular joint(TMJ)morphological parameters before and after correction in adult patients with class Ⅱ bone malocclusion with high angle.Methods One hundred and sixty-three adult patients with class Ⅱ malocclusion and high angles in our hospital from January 2019 to January 2024 were selected.The cone-beam computed tomography(CBCT)imaging data of the patients were imported into Mimics20 software.The mandibular vertical height control parameters such as anterior skull base-mandibular plane angle(SN-MP),ratio of posterior height to anterior height(S-Go/N-Me)and true mandibular rotation angle(XiPm-SN)were measured.The TMJ morphological parameters such as condylar width(CW),condyle length(CL),condyle volume(CV),condyle surface area(CSA),articular fossa width(FW),articular fossa length(FL),articular fossa depth(FD),articular tuberosity angle(NA),anterior joint space(AS),superior joint space(SS),posterior joint space(RS),condylar middle space(MS),condylar internal space(IS)and condylar external space(ES)were also determined.The correlation between mandibular vertical height control parameters and TMJ morphological parameters were analyzed.Results After correction treatment,SN-MP angle,S-Go/N-Me angle,and XiPm-SN angle of the patients were significantly reduced(P<0.05).After correction,CW,CL,CV,CSA,FW,FD,and NA angles were obviously increased,while IS and ES angles were markedly decreased.However,FL,AS,SS,RS and MS angles were unchanged.△SN-MP angle showed positive correlation with△IS and△ES(P<0.05),whereas△S-Go/N-Me angle exhibited negative correlation with△CW and△FW(P<0.05).Both△XiPm-SN angle and△IS/ES angles demonstrated positive correlations(P<0.05).Conclusions The changes of SN-MP angle,S-Go/N-Me and XiPm-SN angle before and after correction are related to the width of condyle and fossa and the internal/external space of condyle.Using this as a reference for the design of micro-implant anchorage is helpful to obtain good height control of the mandible.So that,the lateral profile of adult skeletal Class Ⅱ malocclusion patients with high angles can be improved.
作者
郜罕
赵彦霞
陈捷
尹志刚
王逸群
刘平燕
张翠芬
GAO Han;ZHAO Yan-xia;CHEN Jie;YIN Zhi-gang;WANG Yi-qun;LIU Ping-yan;ZHANG Cui-fen(Handan Stomatological Hospital,Handan 056000,China)
出处
《实用医院临床杂志》
2026年第1期136-141,共6页
Practical Journal of Clinical Medicine
基金
河北省医学研究计划(编号:24422083149ZC)。
关键词
骨性Ⅱ类错[牙合]
高角
垂直高度控制
颞下颌关节
相关性
Malocclusion of bone classⅡ
High angle
Vertical height control
Temporomandibular joint
Correlation
