解剖学报

解剖学报 ›› 2017, Vol. 48 ›› Issue (6): 715-720.doi: 10.16098/j.issn.0529-1356.2017.06.014

• 解剖学 • 上一篇    下一篇

无症状颞下颌关节盘前移位个体的动态磁共振及髁突运动轨迹特点

郑红1 张志光2 张松梅3 薛鹏4*   

  1. 1.河南大学基础医学院病理生理学教研室，河南 开封 475004;  2.中山大学光华口腔医学院附属口腔医院口腔颌面外科，广州 510055; 3.上海交通大学医学院附属第九人民医院口腔修复科，上海 200011; 4.河南大学基础医学院抗体药物开发技术国家地方联合工程实验室，河南 开封 475004
  • 收稿日期:2017-04-14 修回日期:2017-06-10 出版日期:2017-12-06 发布日期:2017-12-06
  • 通讯作者: 薛鹏 E-mail:xuepeng1978@googlemail.com
  • 基金资助:
    牙龈卟啉单胞菌酪氨酸激酶在牙周炎防治中的分子生物学机制研究

Characteristics of Cine-MRI and condylar movement trajectory of asymptomatic subjects with anterior disc displacement of temporomandibular joint

ZHENG Hong1 ZHANG Zhi-guang2 ZHANG Song-mei3 XUE Peng 4*   

  1. 1. Department of Pathophysiology, School of Basic Medical Sciences, He’nan University, He’nan Kaifeng 475004, China; 2.Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Zhongshan University, Guangzhou 510055，China; 3.Department of Prosthodontics, the Ninth People’s hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011,China; 4.National Joint Laboratory for Antibody Drug Development, School of Basic Medical Sciences, He’nan University, He’nan Kaifeng 475004, China
  • Received:2017-04-14 Revised:2017-06-10 Online:2017-12-06 Published:2017-12-06
  • Contact: XUE Peng E-mail:xuepeng1978@googlemail.com

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摘要：

目的 颞下颌关节盘早期的前移位临床上可无弹响症状，了解无症状颞下颌关节盘的早期移位个体的髁突运动中心轨迹特点，将有助于早期发现隐匿性颞下颌关节结构内紊乱疾病。 方法 动态磁共振(Cine-MRI) 和ARCUSdigma系统检查30例无症状个体开闭口过程中髁状突-关节盘运动特点和下颌运动范围。 结果 Cine-MRI显示30例无症状人群中，20例健康颞下颌关节、10例单侧可复性关节盘前移位，闭口位关节盘本体部仍呈双凹形、盘后区均有轻度增厚和前移位，盘-突关系在小开口（<2 cm）期恢复正常；无症状可复性关节盘的运动中心轨迹出现弹跳切迹和偏摆，光滑性、重复性及双侧运动中心轨迹的对称性不及健康人，但是切点运动轨迹平滑，与健康人的切点运动轨迹基本一致；运动轴在髁突轨迹弹跳时出现偏斜，然后保持平行，呈现开闭口初、末时密度比开闭口中时大；髁突运动中心运动距离（13.6±3.7）mm，下颌切点运动距离（40.5±3.4）mm。 结论 髁突运动轨迹能间接反映髁突-关节盘复合体在开闭口运动中的位置变化，为下一步临床使用下颌运动轨迹仪作为早期关节盘移位的诊断提供一定的理论参考。

关键词: 颞下颌关节, 动态磁共振, ARCUSdigma, 人

Abstract:

Objective The initial anterior disc displacement with reduction of temporomandibular joint can be asymptomatic, however the condylar movement trajectory can help early detection of occult temporomandibular joint internal disorders. Methods Appling Cine-MRI and ARCUSdigma system to investigate 30 asymptom temporomandibular joints in open-close movement. Results Ten anterior displacement discs were detected in some asymptom temporomandibular joints, temporomandibular joint discs showed biconcave shape in anterior displacement disc with reduction (ADDwR) individuals, but slightly thickness and anterior displacement, disc-condyle position returned to normal during small opening (<2 cm); In the group of anterior disc displacement with reduction without any symptom, the condyle tracking was found bounce, inflexion and asymmetry and some of incisor tracking were smooth and superposition and others showed segregated curves; The range of opening movement and maximal value of condylar movement and incisor movement respectively were (13.6±3.7) mm and (40.5±3.4) mm respectively. Conclusion The condylar movement trajectory could indirectly detect the changes of shapes and position of articular disc of temporomandibular joint during opening movement, which is helpful to diagnosis early ADDwR without symptom.

Key words: Temporomandibular joint, Cine-MRI, ARCUSdigma, Human