55例特发性髁突吸收患者临床特点与颅颌面结构特征分析

doi:10.19438/j.cjoms.2022.06.004

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (6): 541-547.doi: 10.19438/j.cjoms.2022.06.004

55例特发性髁突吸收患者临床特点与颅颌面结构特征分析

吕政展^*, 朱柏恺^*, 郑美里, 刘旌毅, 汪席均, 洪越扬, 江凌勇

上海交通大学医学院附属第九人民医院口腔颅颌面科,上海交通大学口腔医学院,国家口腔医学中心, 国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海 200011

收稿日期:2022-06-13 修回日期:2022-08-09 出版日期:2022-11-20 发布日期:2022-11-20
通讯作者: 江凌勇,E-mail: jianglingyong@sjtu.edu.cn
作者简介:吕政展（1996-），男，硕士研究生，E-mail: bluesclera15@qq.com；朱柏恺（1996-），男，硕士研究生，E-mail: grigorzhu@gmail.com。*并列第一作者
基金资助:
国家自然科学基金（81870740,82071083,82271006,82101048）; 上海市优秀学术/技术带头人计划（20XD1422300）; 上海市“医苑新星”青年医学人才培养资助计划—杰出青年医学人才项目（HWJRS2019-72）; 上海申康医院发展中心临床三年行动计划（SHDC2020CR4084）; 上海交通大学医学院附属第九人民医院临床研究推助计划（临+计划）（JYLJ201807）; 上海交通大学医学院附属第九人民医院生物样本库项目（YBKB201919）; 上海交通大学医学院高水平创新团队激励计划- 协同创新团队激励项目(SSMU-ZLCX20180501); 上海交通大学医学院附属第九人民医院交叉基金（JYJC202116）

Clinical features and cranio-maxillofacial structure in 55 patients with idiopathic condyle resorption

LYU Zheng-zhan, ZHU Bo-kai, CHUNG Miri, LIU Jing-yi, WANG Xi-jun, HONG Yue-yang, JIANG Ling-yong

Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2022-06-13 Revised:2022-08-09 Online:2022-11-20 Published:2022-11-20

摘要/Abstract

摘要： 目的探讨特发性髁突吸收（idiopathic condyle resorption,ICR）患者的临床特点及颅颌面结构的影像学特征。方法收集2010年1月—2018年12月在上海交通大学医学院附属第九人民医院就诊的55例ICR患者及55例关节健康的骨性Ⅱ类错患者（对照组）。对ICR患者的性别、年龄、单双侧发病情况及相关的关节症状进行统计,分析ICR患者的临床特点。利用二维头影测量及三维重建测量相关的颅颌面部指标,比较2组人群颅颌面结构特征的异同。采用SPSS 25.0软件包对数据进行统计学分析。结果 ICR女性患者占比92.7%,平均就诊年龄（22.17±3.46）岁,双侧关节发病占87%,29.1%的患者曾有关节症状。二维测量显示ICR组的SNA、A-NP、Co-A、SNB、Go-Me、Co-Go和S-Go/N-Me等指标显著小于对照组（P<0.05）,而MP-SN和Y-Axis显著大于对照组（P<0.05）,2组的S-N差异无统计学意义（P>0.05）。三维测量显示,ICR组除Se-Ne、CoR-Ae和SNLp-GoL外,其余测量值均显著小于对照组（P<0.05）。结论 ICR好发于女性,平均就诊年龄22岁,病变多累及双侧关节,不到1/3的患者出现关节症状。相比关节健康的骨性Ⅱ类患者,ICR患者下颌骨严重后缩,下颌体与下颌支更短且多数为高角状态,后前面高比例明显偏小,同时上颌前突并不明显。

关键词: 特发性髁突吸收, 颅颌面结构, 骨性Ⅱ类错畸形, 头影测量, 三维测量

Abstract: PURPOSE: To investigate the clinical and imaging features of craniomaxillofacial structures in patients with idiopathic condyle resorption(ICR). METHODS: A total of 55 ICR patients and 55 skeletal Class Ⅱ patients with healthy temporomandibular joint (control group) were collected in Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from January 2010 to December 2018. The gender, age, unilateral and bilateral incidence of ICR patients and related joint symptoms were statistically analyzed, and the clinical characteristics of ICR patients were analyzed. The cranial-maxillofacial structures of the two groups were compared by using two-dimensional cephalometry and three-dimensional reconstruction. SPSS 25.0 software package was used for data analysis. RESULTS: The proportion of female patients with ICR was 92.7%, the mean age was 22.17±3.46 years old, the incidence of bilateral joint was 87%, 29.1% of patients had joint symptoms. Two-dimensional measurement showed that SNA, A-NP, Co-A, SNB, GO-Me, Co-GO and S-Go/N-Me indicators in ICR group were significantly lower than those in the control group(P<0.05), while MP-SN and Y-axis were significantly higher than those in the control group (P<0.05), there was no significant different in S-N between the two groups(P>0.05). The measured values of ICR group were all lower than those of the control group except SE-NE, COR-AE and SNLP-GOL, and the difference was statistically significant (P<0.05). CONCLUSIONS: ICR usually occurs in women, with an average age of 22 years. The lesions mostly involve bilateral joints, and less than 1/3 of patients have joint symptoms. Compared with the skeletal Class Ⅱ patients with healthy joints, ICR has the cranio-maxillofacial structural characteristics of severe retraction of the mandible, shorter mandibular body and mandibular ramus, and most of them are in the state of high angle, the high posterior-anterior ratio is significantly smaller, and the maxillary protuberance is not obvious.

Key words: Idiopathic condyle resorption, Skeletal Class Ⅱ malocclusion, Cranial maxillofacial structure, Cephalometric measurement, Three-dimensional measurement

中图分类号:

R783.5

吕政展, 朱柏恺, 郑美里, 刘旌毅, 汪席均, 洪越扬, 江凌勇. 55例特发性髁突吸收患者临床特点与颅颌面结构特征分析[J]. 中国口腔颌面外科杂志, 2022, 20(6): 541-547.

LYU Zheng-zhan, ZHU Bo-kai, CHUNG Miri, LIU Jing-yi, WANG Xi-jun, HONG Yue-yang, JIANG Ling-yong. Clinical features and cranio-maxillofacial structure in 55 patients with idiopathic condyle resorption[J]. China J Oral Maxillofac Surg, 2022, 20(6): 541-547.

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55例特发性髁突吸收患者临床特点与颅颌面结构特征分析

Clinical features and cranio-maxillofacial structure in 55 patients with idiopathic condyle resorption

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