Three-dimensional analysis of the temporomandibular joint disk position and configulation

颞下颌关节（TMJ）内紊乱的诊断方法主要有关节造影、关节镜、CT、MRI等，但对颞下颌关节盘的内、外侧移位的诊断尚不充分，本研究旨在利用三维重建图像分析颞下颌关节盘的位置和运动。材料和方法如下：1。我们制作了一个颞下颌关节体模，该体模由一个干颅骨和一个人工椎间盘组成.通过扫描TMJ模型获得CT图像和断层摄影图像。3.通过使用3D分析设备（COSMOZONE 2SB，NIKON Co.ltd.，日本）。将3D图像与2D图像的颞下颌关节盘位置进行对比分析，3D图像对颞下颌关节盘位置的诊断有一定的帮助，尤其是外侧、内侧、前内侧和前外侧移位。在对3D图像进行诊断时，上级方向的3D图像优于侧位或额位，并对临床关节断层图像重建的3D图像（133例怀疑内部紊乱的患者）进行分析。椎间盘前移位率为84%。仅1例（5%）为椎间盘内侧移位。关节盘前外侧或前内侧移位占29%，关节盘形态扭曲占75%。

Internal derangement of the temporomandibular joint (TMJ) has been evaluated by using Arthrography, Arthroscopy, Computed Tomographt (CT) or Magnetic Resonance Imaging.But it is not enough to evaluate lateral or medial displacement of the TMJ disk.The purpose of this research is to analyze the TMJ disk position and configulation by using three-dimensional (3D) reconstruction image. The material and method is as follows ;1. We made a TMJ phantom which was composed a dry-skull and a artificial disk.2. CT images and tomographic images were obtained by scanning the TMJ phantom.3.3D images of CT and tomographic images were reconstructed by using 3D analyzing equipment (COSMOZONE 2SB, NIKON Co.ltd., Japan).4. We correlated and analyzed with TMJ disk position of 3D image and 2D image.3D image was useful to diagnose the TMJ disk position, especially lateral, medial, antero-medial and antero-lateral displacement. When we diagnosed 3D image, 3D image from superior direction was better than from lateral or frontal direction.And following, we analyzed 3D images reconstructed from clinical arthrotomographic images (133 patients who doubt internal derangement). Anterior disk displacement was 84%. Only 1 case (5%) was medial disk displacement. Antero-lateral or antero-medial disk displacement was 29%.Configulation of the TMJ disk distorted 75%.