成人颞下颌关节骨关节病骨性改变与Helkimo指数的关系

目的: 应用锥形束CT（CBCT）研究成人颞下颌关节骨关节病临床症状、体征与关节区CBCT影像学改变之间的联系,为临床诊断提供参考。方法: 选取81例同时具有CBCT影像资料及临床检查记录资料的颞下颌关节骨关节病患者作为研究对象,应用Invivo 5 软件重建影像资料后进行颅面测量并记录。选定关节区图像后,记录颞下颌关节骨性改变,按Helkimo方法整理并记录临床检查结果,应用SPSS 22.0软件包对实验结果进行Spearman等级相关分析。结果: Helkimo指数与颞下颌关节骨关节病髁突骨质变化（P<0.01）及关节窝骨质改变相关（P<0.05）,但与颞下颌关节间隙改变不相关（P>0.05）。结论: 应用CBCT对颞下颌关节骨关节病关节区骨质改变进行观察（包括下颌骨髁突、关节窝骨质）,对临床诊断及判断疾病严重程度有一定指导意义,但是对颞下颌关节间隙改变无提示意义。

Study about the relationship between the structural features of adult temporomandibular joint osteoarthritis and Helkimo index by cone-beam CT

PURPOSE: Use of cone-beam computer tomography (CBCT) to investigate the relationship between clinical symptoms, signs of adult temporomandibular joint osteoarthritis(TMJOA) and the imaging changes in order to provide reference for clinical diagnosis. METHODS: Eighty-one cases with CBCT images and clinical data were selected. Craniofacial items and TMJ images were measured by using Invivo 5 software and recorded. The final data were analyzed with SPSS 22.0 software package for Spearman rank correlation analysis. RESULTS: A significant correlation was found between Helkimo index and TMJ bony changes in condyle and glenoid fossa (P<0.01). However, no relationship with TMJ space changes was displayed (P>0.05). CONCLUSIONS: Use of CBCT to observe TMJOA bony changes (include mandibular condyle, joint fossa) is helpful for the diagnosis and judgment of disease severity, but not for displaying temporomandibular joint space changes.