Study Of SPECT/CT Fusion Imaging Of Temporomandibular Joint In Adults With Mandibular Deviation

Mandibular deviation is one of the most frequent malocclusions in adult patients. It affect seriously not only face but also occlusion function and spine posture, even lead to temporomandibular joint disorder. The severity of the deformity increases with the growth of individual, and have development trend from mandible shift to the genuine skeleton deformity. Without discovery and treatment in an early stage, the functional mandibular shift might develop into genuine skeletal deformity.Studies had suggested that for adults with mandibular deviation, morphology and position's asymmetry change of mandible could lead to adaptability rebuild in the area of temporomandibular joint. Except the morphology of condyloideus, morphology of acetabulum and position of condyloideus also appearanced asymmetry rebuild, and the changes of condyloideus had some association with TMD. Except the asymmetry of temporomandibular joint, the functions of bilateral masticatory muscles dyssynchrony. The abnormality of masticatory muscles is one reseaon of deviation.Anterior studys with temporomandibular joint in mandibular deviation always restrict at morphology aspect. Such as x-ray picture, 3-dimensional reconstruction based on CT radiographs and so on. It could not showed the bilateral difference of functions and the information of metabolism and blood supply of bone. Radionuclide bone imaging reflects obviously susceptiveness in the examine of bone and joints disease. But the space resolution of Radionuclide bone imaging were insufficient, result she localization of morbid change lack exactness. The appearance of SPECT/CT fusion imaging, combined both advantage of SPECT and CT, could supply both strict localization and metabolism information. In this experiments, we use the techniques of SPECT/CT, to research the variability of temporomandibular joint in adults with mandibular deviation from functional aspect. And now, there had no reports in the study of SPECT/CT fusion imaging of temporomandibular joint in adults with mandibular deviation.The study consists of three parts:1. Comparison of SPECT/CT fusion imaging in bilateral temporomandibular joint in adults with mandibular deviation.Select 20 patients with mandibular deviation for the study object. Accepted examination of SPECT/CT. The ROI was setup in different localization of mandible, and the radioactive counting was obtained. Then compared the variability of patients with mandibular deviation in different ROI through semiquantitative analysis. The result showed that: there were definite differences of bone blood stream and metabolism in different localization of mandible in adults with mandibular deviation, all of the radioactive intensity of contralateral side more stronger then deviate side. The radioactive counting of condyle process is the most, then the angle of mandible, and the ascending branch of mandible was minimum. The bilateral variability showed: the condyle process was the most, then the angle of mandible, and the ascending branch of mandible was minimum.2. Comparison of SPECT/CT fusion imaging in bilateral temporomandibular joint of normal occlusion people.Select 6 normal occlusion people for the control group. Accepted examination of SPECT/CT. The same ROI as the study object was setup in different localization of mandible, and the radioactive counting was obtained. Then compared the variability of normal occlusion people in different ROI through semiquantitative analysis. The result showed that: the radioactive counting ratios of bilateral different ROI of normal occlusion people approached 1, the bilateral symmetry was well.3. Compared the variability of temporomandibular joint in normal occlusion people and patients with mandibular deviation.Select 20 patients with mandibular deviation for the study object, and 6 normal occlusion people for the control group. Accepted examination of SPECT/CT. The ROI was setup in different localization of mandible, through the radioactive counting ratios, compared the variability of temporomandibular joint in normal occlusion people and patients with mandibular deviation. The result showed that: the bilateral radioactive counting ratios of normal occlusion people approached 1, the bilateral symmetry was well. Compared with control group, the bilateral radioactive counting ratios of patients with mandibular deviation(contralateral side contrast deviate side) was larger than 1. Explained that the radioactive intensity of contralateral side more stronger then deviate side. The variability of different ROI had statistical significance, the condyle process was the most, then the angle of mandible, and the ascending branch of mandible was minimum.