中华口腔正畸学杂志
中華口腔正畸學雜誌
중화구강정기학잡지
CHINESE JOURNAL OF ORTHODONTICS
2013年
3期
135-139
,共5页
骨性Ⅲ类%正畸正颌%髁突位置%关节间隙
骨性Ⅲ類%正畸正頜%髁突位置%關節間隙
골성Ⅲ류%정기정합%과돌위치%관절간극
Skeletal class Ⅲ malocclusion%Orthodontic-orthogonathic treatment%Condylar position%Joint space
目的 测量骨性Ⅲ类患者经过正畸正颌联合治疗后各个阶段关节间隙的变化,分析髁突在关节窝中的位置,探讨正畸正颌联合治疗后髁突位置的长期稳定性.方法 选择15例经过正畸正颌联合治疗后的骨性Ⅲ类患者,收集患者术前(T1)、术后1周(T2)、术后正畸结束时(T3)、3～12年随访复诊时(T4)的双侧关节许勒位片,采用国内外常用的两种方法对各个阶段关节间隙进行测量,计算各个阶段关节间隙ln(p/A)值,通过配对样本t检验,分析T2-T1、T3-T1、T4-T1的变化.结果 15例患者经过正畸正颌联合治疗后双侧关节的前、后、上间隙均发生明显变化;采用国内常用的张震康法测量左侧关节的前、后、上间隙术后一周分别为(2.22±0.30) mm、(5.14±1.49) mm、(5.00±0.63) mm,术前分别为(1.87±0.45) mm、(2.96±0.32) mm、(2.83±0.67) mm,P值分别为0.025、0.005、0.003,有统计学意义;右侧关节的后、上间隙术后1周分别为(6.02±0.19) mm、(6.05±1.27) mm,术前分别为(2.88±0.98) mm、(3.32±0.18) mm,P值均＜0.001,有统计学意义;T3、T4分别与T1比较,关节前、上、后间隙的差异均无统计学意义.采用国外常用的Kamelchuk法测量结论一致.结论 正颌手术后1周关节间隙有一定程度增大,尤其是关节后间隙和上间隙,而到了治疗结束时,关节间隙恢复至术前状态并会维持长期(3～12年)稳定,在各个阶段髁突位置均表现为中性位.
目的 測量骨性Ⅲ類患者經過正畸正頜聯閤治療後各箇階段關節間隙的變化,分析髁突在關節窩中的位置,探討正畸正頜聯閤治療後髁突位置的長期穩定性.方法 選擇15例經過正畸正頜聯閤治療後的骨性Ⅲ類患者,收集患者術前(T1)、術後1週(T2)、術後正畸結束時(T3)、3～12年隨訪複診時(T4)的雙側關節許勒位片,採用國內外常用的兩種方法對各箇階段關節間隙進行測量,計算各箇階段關節間隙ln(p/A)值,通過配對樣本t檢驗,分析T2-T1、T3-T1、T4-T1的變化.結果 15例患者經過正畸正頜聯閤治療後雙側關節的前、後、上間隙均髮生明顯變化;採用國內常用的張震康法測量左側關節的前、後、上間隙術後一週分彆為(2.22±0.30) mm、(5.14±1.49) mm、(5.00±0.63) mm,術前分彆為(1.87±0.45) mm、(2.96±0.32) mm、(2.83±0.67) mm,P值分彆為0.025、0.005、0.003,有統計學意義;右側關節的後、上間隙術後1週分彆為(6.02±0.19) mm、(6.05±1.27) mm,術前分彆為(2.88±0.98) mm、(3.32±0.18) mm,P值均＜0.001,有統計學意義;T3、T4分彆與T1比較,關節前、上、後間隙的差異均無統計學意義.採用國外常用的Kamelchuk法測量結論一緻.結論 正頜手術後1週關節間隙有一定程度增大,尤其是關節後間隙和上間隙,而到瞭治療結束時,關節間隙恢複至術前狀態併會維持長期(3～12年)穩定,在各箇階段髁突位置均錶現為中性位.
목적 측량골성Ⅲ류환자경과정기정합연합치료후각개계단관절간극적변화,분석과돌재관절와중적위치,탐토정기정합연합치료후과돌위치적장기은정성.방법 선택15례경과정기정합연합치료후적골성Ⅲ류환자,수집환자술전(T1)、술후1주(T2)、술후정기결속시(T3)、3～12년수방복진시(T4)적쌍측관절허륵위편,채용국내외상용적량충방법대각개계단관절간극진행측량,계산각개계단관절간극ln(p/A)치,통과배대양본t검험,분석T2-T1、T3-T1、T4-T1적변화.결과 15례환자경과정기정합연합치료후쌍측관절적전、후、상간극균발생명현변화;채용국내상용적장진강법측량좌측관절적전、후、상간극술후일주분별위(2.22±0.30) mm、(5.14±1.49) mm、(5.00±0.63) mm,술전분별위(1.87±0.45) mm、(2.96±0.32) mm、(2.83±0.67) mm,P치분별위0.025、0.005、0.003,유통계학의의;우측관절적후、상간극술후1주분별위(6.02±0.19) mm、(6.05±1.27) mm,술전분별위(2.88±0.98) mm、(3.32±0.18) mm,P치균＜0.001,유통계학의의;T3、T4분별여T1비교,관절전、상、후간극적차이균무통계학의의.채용국외상용적Kamelchuk법측량결론일치.결론 정합수술후1주관절간극유일정정도증대,우기시관절후간극화상간극,이도료치료결속시,관절간극회복지술전상태병회유지장기(3～12년)은정,재각개계단과돌위치균표현위중성위.
Objective To investigate the changes and long-term stability of temporomandibular joint positions during and after orthodontic-orthogonathic treatment.Methods 15 patients with skeletal class Ⅲ malocclusion were included in this study.All patients received orthodonticorthognathic treatment.Anterior,posterior and upper spaces of bilateral condyles were measured at time of pretreatment,1 week after surgery,end of treatment and 3 to 12 year of follow-up.The value of ln(p/A) were measured,and paired t test were done to analyze the value changes between stages (T2-T1,T3-T1,T4-T1).Results 15 patients all experienced significant condyle position changes in all spaces.Zhang's measurement showed the left condyle spaces were(2.22± 0.30)mm,(5.14±1.49)mm,and(5.00± 0.63)mm for anterior,posterior,and upper space respectively at 1 week after surgery,comparing with (1.87±0.45)mm、(2.96±0.32)mm、(2.83±0.67) mrn at pre-surgery.Changes were significant(P level were 0.025,0.005,0.003 respectively).For right condyle position,posterior and upper spaces were(6.02 ±0.19)mm and (6.05 ± 1.27)mm at 1 week after surgery,comparing with(2.88 ± 0.98) mm and (3.32 ± 0.18) mm at pre-surgery.Changes were significant (P＜0.001).For the changes of both condyles positionts between T3 and T1,T4 and T1,anterior,posterior and upper spaces had no significant differences.Using Kamelchuk measurement,the results were the same.Conclusions Condyle positions at 1 week after surgery showed some extent of increase,especially for posterior and upper spaces.At end of treatment,however,the spaces recovered to the same status as in pre-treatment and remained stable in long term follow-up(3 12 yrs).In all stages,the condyles were in central positions.
