青少年单侧颞下颌关节盘前移位患者面部不对称的特征

中国口腔颌面外科杂志 ›› 2014, Vol. 12 ›› Issue (1): 69-73.

青少年单侧颞下颌关节盘前移位患者面部不对称的特征

谢千阳, 马志贵, 杨驰, 蔡协艺

上海交通大学医学院附属第九人民医院·口腔医学院口腔外科,上海市口腔医学重点实验室,上海 200011

收稿日期:2013-04-01 修回日期:2013-06-26 出版日期:2014-02-10 发布日期:2014-02-10
通讯作者: 杨驰,Tel：021-23271699-5707,E-mail：yangchi63@hotmail.com
作者简介:谢千阳(1986-),男,硕士,住院医师,E-mail：xieqianyang86@gmail.com

Characteristics of facial asymmetry of patients with juvenile unilateral temporomandibular joint anterior disc displacement

XIE Qian-yang, MA Zhi-gui, YANG Chi, CAI Xie-yi

Department of Oral Surgery, Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2013-04-01 Revised:2013-06-26 Online:2014-02-10 Published:2014-02-10

摘要/Abstract

摘要： 目的: 研究青少年单侧颞下颌关节盘前移位患者面部不对称畸形的特点及其与盘前移位的关系。方法：收集经磁共振确诊为单侧颞下颌关节盘前移位的10~20岁青少年单侧盘前移位连续病例,进行X线头颅定位正位片检查并测量,采用SPSS 18.0软件包,使用独立样本t检验分析左侧移位组和右侧移位组下颌骨(颏部、下颌角、髁突)、上颌骨(前鼻棘、颧牙槽嵴)和牙列(上、下牙列中点)不对称的特点。结果：105例10~20岁(平均16.76岁)青少年单侧盘前移位患者中,下颌偏斜患者67例(63.81%)。单侧盘前移位患者移位侧下颌骨垂直向高度不足,下颌角离散度增大,颏中线和上、下颌牙列中线向移位侧偏斜(P<0.05)。左侧盘前移位患者上颌骨未见显著不对称(P>0.05),右侧盘前移位患者上颌骨显著不对称(P<0.05)。结论：青少年单侧关节盘前移位患者表现出明显的面部不对称,且与单侧盘前移位患病侧紧密相关。面部不对称以下颌骨最为明显,表现为颏部偏向移位侧,以及下颌骨整体向移位侧旋转；上颌骨则表现出移位侧垂直向发育受影响的趋势。

关键词: 青少年, 颞下颌关节盘前移位, 面部不对称畸形, 下颌偏斜

Abstract: PURPOSE: To study the characteristics of facial asymmetry of adolescent unilateral temporomandibular anterior disc displacement patients, and clarify the relationship of facial asymmetry and disc displacement. METHODS: Consecutive juvenile patient of 10 to 20 year-old with unilateral temporomandibular anterior disc displacement confirmed by magnetic resonance imaging were collected, posteroanterior cephalometric radiographs were taken and measured. SPSS 18.0 software package was employed to analyze the asymmetry of mandible (menton, gonion, condyle), maxilla (anterior nasal spine, zygomatic alveolar ridge) and dentition (the midpoint of the upper and lower dentition) within both left and right disc displacement through one sample t test. RESULTS: One hundred and five cases aging from 10 to 20 years old (mean 16.76 years) with unilateral disc displacement were collected, 67 (63.81%) were diagnosed as mandibular deviation. Patient with unilateral disc displacement displayed decrease of vertical height of ramus, increase of dispersion of gonion on the ipsilateral side, and shift of midline of chin and upper and lower dentition to the same side (P<0.05). There was significant asymmetry of the maxilla in the right disc displacement group (P<0.05), but no asymmetry in the left disc displacement group (P>0.05). CONCLUSION: Teenagers with unilateral anterior disc displacement showed significant facial asymmetry and its characteristics was closely related to the ipsilateral side of disc displacement. Facial asymmetry affected mostly mandible with the chin deviated and overall rotation of mandible to the ipsilateral side. There is a tendency that development of maxilla on the ipsilateral side was affected.

Key words: Juvenile, Anterior disc displacement, Facial asymmetry, Mandibular deviation

谢千阳, 马志贵, 杨驰, 蔡协艺. 青少年单侧颞下颌关节盘前移位患者面部不对称的特征[J]. 中国口腔颌面外科杂志, 2014, 12(1): 69-73.

XIE Qian-yang, MA Zhi-gui, YANG Chi, CAI Xie-yi. Characteristics of facial asymmetry of patients with juvenile unilateral temporomandibular joint anterior disc displacement[J]. China J Oral Maxillofac Surg, 2014, 12(1): 69-73.

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