摘要
目的:探讨青少年颞下颌关节骨关节病(temporomandibular joint osteoarthrosis,TMJOA)患病情况及锥形束CT(cone beam computed tomography,CBCT)X线片征象。方法:选取北京大学口腔医学院颞下颌关节病及口面痛治疗中心就诊的10～19岁颞下颌关节紊乱病(temporomandibular disorders,TMD)患者386例为患者组,因错牙合畸形于北京大学口腔医学院正畸科就诊的10～19岁患者339例为对照组,两组病例均采用CBCT进行双侧颞下颌关节扫描。对两组患者TMJOA检出率及X线片征象进行分类比较。应用SPSS 13.0统计软件对两组数据进行统计分析。结果:(1)患者组TMJOA病例157例,检出率40.7%(157/386),对照组TMJOA病例41例,检出率12.1%(41/339),患者组TMJOA检出率高于对照组,差异有统计学意义(P<0.05)。(2)患者组男性和女性TMJOA检出率分别为30.9%(34/110)和44.6%(123/276),差异有统计学意义(P<0.05);对照组分别为8.6%(9/105)和13.7%(32/234),差异没有统计学意义(P>0.05)。(3)对两组TMJOA骨质改变类型构成比进行比较,患者组髁突骨皮质模糊(31.7%,65/205)、骨质小凹陷缺损和骨质较广泛破坏(共占25.4%,52/205)高于对照组[髁突骨皮质模糊占1/58(1.7%),骨质小凹陷缺损和骨质较广泛破坏共占3/58(5.2%),P均<0.05],对照组髁突磨平变短(39.7%,23/58)和骨质硬化(39.7%,23/58)高于患者组[髁突磨平变短占13/205(6.3%),骨质硬化占30/205(14.6%),P均<0.05]。结论:青少年TMD患者及正畸患者中骨关节病并不罕见,TMD患者组骨关节病病例女性多见。患者组与对照组TMJOA X线片征象中溶解破坏类(包括髁突骨皮质模糊、骨质小凹陷缺损和骨质较广泛破坏)和相对稳定类(骨质硬化、骨质增生、囊样变、骨质磨损和磨平变短)的构成比差异有统计学意义。
Objective ： To investigate the occurrence and radiographic signs of osteoarthrosis of the tem- poromandibular joints （TMJOA） with cone beam computed tomography （CBCT） in adolescents. Methods： Individuals with temporomandibular disorders （aged 10 - 19 years） in the patients group （n = 386 ） and pre-orthodontic patients with malocclusion （aged 10 - 19 years） in the control group （n = 339 ） were included in the present study. All the patients in both groups had been examined by CBCT. The ab-normalities of the condyle were evaluated. The results of radiological findings were comparedbetween the patients group and the controls by using chi-square tests. Inter-and intra-examiner agreements were as- sessed using Cohen＇ s Kappa coefficient and all statistical analysis was performed using SPSS 13.0. Results ：157 patients in the patients group and 41 subjects in the control group had radiographic signs of TMJOA. The occurrence of OA was significantly higher in the patients group （40.7%, 157/386） than in the controls （12.1%, 41/339）, the difference was statistically significant （P 〈 0.05 ）. The occurrence of TMJOA was significantly higher in females （44.6% , 123/276） than in males （30.9% , 34/110） in the patients group （ P 〈 0.05 ） but showed no significant difference in the controls （ females： 13.7%, 32/234, and male ： 8.6%, 9/105, P 〉 0.05 ）. In addition, the patients group showed significantly higher occurrence of ill-defined cortical bone （31.7% , 65/205 ） small bony defect and extensive erosion （25.4%, 52/205） than the controls （1.7%, 1/58 and 5.2%, 3/58, respectively, P 〈0.05）, while the subjects in the control group had significantly higher occurrence of flattening and shortening of the condyle （39.7%, 23/58） and sclerosis （39.7%, 23/58） than patients with temporomandibular disor-ders （6.3%, 13/205 and 14.6%, 30/205, respectively, P 〈0.05）. Conclusion： TMJOA is not un-common in adolescent patients with TMD and with malocclusion. Patients in the two study groups had dif-ferent radiographic signs of OA. The patients with temporomandibular disorders often demonstrate erosive changes, while the pre-orthodontic patients with malocclusion often demonstrate relatively stable radio-graphic signs.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2013年第2期280-285,共6页
Journal of Peking University:Health Sciences
关键词
颞下颌关节障碍
骨关节炎
锥束计算机体层摄影术
错牙合
青少年
Temporomandibular joint disorders
0steoarthritis
Cone-beam computed tomography
Malocclusion
Adolescent
