国际口腔医学杂志

国际口腔医学杂志 ›› 2020, Vol. 47 ›› Issue (5): 567-573.doi: 10.7518/gjkq.2020083

• 综述 • 上一篇    下一篇

伴发于偏颌畸形的颞下颌关节内部结构变化

殷晓丽1(),刘洋2,王军1()   

  1. 1.口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院正畸科 成都 610041
    2.口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院颞颌关节科 成都 610041
  • 收稿日期:2019-12-09 修回日期:2020-05-21 出版日期:2020-09-01 发布日期:2020-09-16
  • 通讯作者: 王军
  • 作者简介:殷晓丽,硕士,Email: 996632788@qq.com
  • 基金资助:
    国家自然科学基金(81771114)

Internal structural changes of the temporomandibular joint associated with mandibular lateral displacement

Yin Xiaoli1(),Liu Yang2,Wang Jun1()   

  1. 1.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2019-12-09 Revised:2020-05-21 Online:2020-09-01 Published:2020-09-16
  • Contact: Jun Wang
  • Supported by:
    National Natural Science Foundation of China(81771114)

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摘要：

偏颌是临床常见的颅颌面畸形,临床多表现为各种方式的下颌骨偏斜。除外观改变之外,偏颌患者常伴有颞下颌关节内部结构（髁突、关节盘）和口颌系统功能的改变,这一特点会增加临床全面诊断和治疗偏颌的难度,明确下颌偏斜方式和关节内部各结构的变化情况,对于偏颌畸形的全面诊疗有重要意义。但是,目前针对此问题的研究尚不充足,本文从偏颌患者伴有的颞下颌关节内部结构的变化和下颌偏斜方式可能存在的联系作一综述,以便临床医生参考。

关键词: 偏颌, 颞下颌关节, 髁突, 关节盘

Abstract:

Mandibular lateral displacement is a common craniomaxillofacial deformity in clinical practice, which manifests as various forms of mandibular deviation. In addition to changes in appearance, this deformity is often associated with changes in the internal structure of the temporomandibular joint (i.e., condyle and temporomandibular joint disc) and functions of the oral and maxillofacial systems, which increase the difficulty of conducting clinically comprehensive diagnosis and treatment of mandibular lateral displacement. To resolve such difficulty, the forms of mandibular deviation and the changes in the internal structure of the temporomandibular joint must be analyzed and clarified. However, the existing research on this topic is not sufficient. Therefore, this study reviews the possible relationship between the changes in the internal structure of the temporomandibular joint and the mandibular deviation in patients with mandibular lateral displacement to provide reference to clinicians.

Key words: mandibular lateral displacement, temporomandibular joint, condyle, disc

中图分类号: 

  • R782.6

图 1

颞下颌关节的正常结构 A:闭口位;B:开口位。1:髁突;2:关节盘;3:关节结节。"

图 2

旋转中心位于牙列"

图 3

旋转中心位于偏斜侧髁突"

图 4

旋转中心位于非偏斜侧髁突"

图 5

髁突位置改变伴随的髁突运动轨迹的变化 A:牙尖交错位时的髁突中心点;A1:牙尖交错位时,髁突后上方移位的中心点;A2:牙尖交错位时,髁突前下方移位的中心点;B:对刃牙合位时的髁突中心点。"

表 1

下颌骨旋转中心的位置对关节内部结构的影响"

旋转中心 分侧 髁突位置 关节盘位置 髁突运动 病因 治疗效果
牙列 偏斜侧 后上 前下移位多见 髁突运动幅度变大,前伸髁道斜度变陡 有一定功能性因素 可改善
非偏斜侧 前下 正常或者前下移位多见 髁突运动幅度变小,前伸髁道斜度变缓
偏斜侧髁突 偏斜侧 关节窝中央 正常多见 基本正常 - -
非偏斜侧 后上 前下移位多见 髁突运动幅度变大,前伸髁道斜度变陡 骨性 无法改善
前下 正常或者前下移位多见 髁突运动幅度变小,前伸髁道斜度变缓 有一定功能性因素 可改善
非偏斜侧髁突 偏斜侧 后上 前下移位多见 髁突运动幅度变大,前伸髁道斜度变陡 有一定功能性因素 可改善
前下 正常或者前下移位多见 髁突运动幅度变小,前伸髁道斜度变缓 骨性 无法改善
非偏斜侧 关节窝中央 正常多见 基本正常 - -
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