| Objective:The objective of this clinical study was to find a relationship between the clinical symptoms,signs of adult temporomandibular joint osteoarthritis(TMJOA)and the imaging changes by cone-beam computer tomography(CBCT),and know more about the characteristics of TMJOA by compared with TMJ structures in adult skeletal class? maloclussion with high-angel TMJOA group and normal TMJ group,then to provide reference for clinical diagnosis.Method:81 patients with CBCT images and clinical inspection data were selected from Tianjin Medical University Stomatology Hopital Orthodontics Department and Temporomandibular Joint Department from 2014 to 2016.20 patients with bilateral TMJOA and high-angle were chosen from those 81 patients as experimental group,and 20 patients with normal TMJ were selected as control group from the same database.81 data were rebuilt and recorded information by using Invivo 5 software,then clinical results were analyzed according Helkimo disorder index with SPSS 22.0software.The experiment data of craniofacial structure and TMJ of two groups were finally analyzed by using SPSS 22.0 software.The paired-t test was used for intra-group and the independent-t test for different groups.Result:1.The total number of female with TMJOA was 69 in 81 cases and male was 12,the different sexual groups was accounted for 85.16% and 14.84%,respectively.2.The TMJOA patients were classified according to the sagittal craniofacial morphology,skeletal Class II was 53/81(65.43%),followed by skeletal class I 21/81(25.93%)and skeletal class ? 7/81(8.64%).The TMJOA patients were classified according to the vertical classification were high angle 41/81(50.62%),normal angle26/81(32.10%)and low angle 14/81(17.28%).The total number of skeletal Class II type with high-angle was 33 cases,accounted for 40.74% in the nine refinement classes.3.A significant correlation was found between Helkimo index and TMJ bonychanges in condyle and glenoid fossa(P < 0.01).However,it failed to find any relationship with TMJ space changes(P > 0.05).4.Compared with the normal control group,the mandibular position of adult skeletal class? with high-angel TMJOA group was more posterior and the mandibular plane angle was significantly larger(P < 0.01).The height of mandibular ramus was significantly lower and mandibular angle was larger(P < 0.05)5.The sagittal anterioposterior diameter,height of condyle in adults skeletal class?with high-angel TMJOA group were lower than control group(P < 0.05),the width of condylar anterior slope was significantly increased(P < 0.01).Condylar level angel was increased in cross section significantly(P < 0.05),the position of condyle in the glenoid fossa remained unchanged(P > 0.05).6.Compared with the normal control group,the forward joint space and the upper joint space decreased,whereas the posterior space increased on sagittal plane in skeletal class?with high-angel TMJOA group(P < 0.05).It was found that the lateral joint space decreased but the medial space increased in coronal plane(P < 0.05).7.The anteoposterior diameters of glenoid fossa was significantly increased(P <0.01),and the thickness of the wall of the glenoid fossa roof was increased too(P <.0.05).The height of the articular tubercle and the inclined angle of the posterior slope were decreased(P < 0.05).Conclusion:1.There were gender differences in the incidence of TMJOA,more women than men.2.There was a relationship between the incidence of TMJOA and abnormal craniofacial types.Skeletal class ?with posterior mandible was the most common type.Patients with high-angle were the major type in vertical direction.Therefore,Skeletal class ? type with high-angle was likely found TMJOA.3.The Helkimo index was significantly correlated with bony changes in mandibular joint,including condyle and glenoid fossa,but not related to the changes of TMJ space.4.The characteristics of mandibular in adult skeletal class?with high-angelTMJOA group were shorter mandibular ramus,greater mandibular angle,mandibular retraction,greater mandibular plane angle and higher ratio of facial height compared with normal control group.5.It is found that there was a significant correlation between the bony changes of the mandibular condyle and glenoid fossa,but there was no correlation between the changes of the TMJ space.6.Compared with the control group,the bony changes of adult skeletal class?with high-angel TMJOA group were:(1)Condylar height decreased,width of sagittal condylar forward slope increased,horizontal transverse condylar angle increased.(2)The shape of the glenoid fossa became wider and shallower,however the wall of the glenoid fossa roof was thickener.the height of the TMJ articular tubercle decreased and the slope became gentle.(3)The change of joint space was observed in the sagittal direction: the posterior gap was reduced,the upper space and the anterior space became larger,and the space on the coronal direction were not changed obviously. |
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