Mandibular asymmetry: a three-dimensional quantification of bilateral condyles.
Mandibular asymmetry: a three-dimensional quantification of bilateral condyles.
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DOI：
10.1186/1746-160x-9-42
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发表时间：
2013-12-20
影响因子：
3
通讯作者：
Zheng Y
中科院分区：
文献类型：
--
作者：
Lin H;Zhu P;Lin Y;Wan S;Shu X;Xu Y;Zheng Y
髁突的形状和体积被认为在下颌偏斜的发病机制中起着重要作用。曲率分析对于客观评估髁突形状是否与关节盂形状匹配具有重要意义。在本研究中，首先对双侧不对称髁突进行三维 (3-D) 量化，以确定 3-D 髁突配置对下颌不对称的具体作用。包括 55 名被诊断为下颌不对称的成年患者，其中 26 名男性（26±5 岁）和 29 名女性（26±5 岁）。进行下巴点偏差、牙齿中线偏差、咬合面倾斜度、下颌咬合面深度的检查。临床调查后，使用患者的计算机断层扫描图像重建 3D 下颌模型。然后对每位患者颞下颌关节非偏斜侧和偏斜侧的髁突体积、表面尺寸、表面曲率和骨密度进行独立评估。偏侧的髁突表面尺寸和体积均明显更大（表面尺寸：1666.14 ± 318.3 mm2，体积：1981.5 ± 418.3 mm3）。髁突前斜率较平坦（0.12±0.06），后斜率（0.39±0.08）在偏斜侧明显凸出。相应的骨密度值为523.01±118.1 HU和549.07±120。前坡和后坡各 6 HU。偏侧的不一致性导致接触面积减少，从而导致接触应力增加和骨密度变化。所有上述结果表明，偏斜髁突和非偏斜髁突之间存在的差异与面部不对称发育相关。在下颌不对称患者中，偏斜侧髁突的 3D 形态与非偏斜侧不同，这表明颌功能不对称与关节重塑之间存在关联。
The shape and volume of the condyle is considered to play an important role in the pathogenesis of the mandibular deviation. Curvature analysis is informative for objectively assess whether the shape of the condyles matches that of the glenoid fossa. In this study, a three-dimensional (3-D) quantification of bilateral asymmetrical condyles was firstly conducted to identify the specific role of 3-D condylar configuration for mandibular asymmetry. 55 adult patients, 26 males (26 ± 5 yrs) and 29 females (26 ± 5 yrs), diagnosed with mandibular asymmetry were included. The examination of deviation of chin point, deviation of dental midlines, inclination of occlusal plane, and depth of the mandibular occlusal plane were conducted. After the clinical investigation, computed tomography images from the patients were used to reconstruct the 3-D mandibular models. Then the condylar volume, surface size, surface curvature and bone mineral density were evaluated independently for each patient on non-deviated and deviated sides of temporomandibular joint. Both the condylar surface size and volume were significantly larger on deviated side (surface size: 1666.14 ± 318.3 mm2, volume: 1981.5 ± 418.3 mm3). The anterior slope of the condyle was flatter (0.12 ± 0.06) and the posterior slope (0.39 ± 0.08) was prominently convex on the deviated side. The corresponding bone mineral density values were 523.01 ±118.1 HU and 549.07 ±120. 6 HU on anterior and posterior slopes. The incongruence presented on the deviated side resulted in a reduction in contact areas and, thus, an increase in contact stresses and changes of bone density. All aforementioned results suggest that the difference existing between deviated and non-deviated condyles correlates with facial asymmetrical development. In mandibular asymmetry patients, the 3-D morphology of condyle on deviated side differ from the non-deviated side, which indicates the association between asymmetrical jaw function and joint remodeling.