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題名 | Cephalometric Craniofacial Characteristics in Patients with Temporomandibular Joint Ankylosis=顳顎關節粘連患者之測顱顱顏型態分析 |
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作者 | 柯雯青; 黃炯興; 陳昱瑞; | 書刊名 | 長庚醫學 |
卷期 | 28:7 2005.07[民94.07] |
頁次 | 頁456-466 |
分類號 | 416.95 |
關鍵詞 | 顳顎關節粘連; 測顱分析; Temporomandibular joint ankylosis; TMJ ankylosis; Cephalometric analysis; |
語文 | 英文(English) |
中文摘要 | 背景:顳顎關節粘連除了造成病患下顎功能障礙及口腔疾患的增加,亦對顏面的發育與形態造成影響。藉由對此類患者顱顏形態精確的了解,以提供治療之參考。 方法:本研究包括長庚醫院顱顏中心歷年來45例顳顎關節連患者,男性21位,女性24位,年齡3至47歲。其中37位為單側,8位為雙側粘連。患者依性別與年齡分組,男性17歲以下,女性15歲以下為生長組,其餘為成人組。調查個別病史及爾病時間並測量治療前側面測顱X光片,包含29項線性及角度變項,與臺灣地區相對應之性別及年齡層之平均值做比較。 結果:造成顳顎關節粘連48.9%為顏面外傷,17%為生產過程之外傷,15.6%為口腔或中耳感染,2.2%為關節炎,其餘原因不明,所有發生張口受限之年齡均於16歲以前。患側下顎總長度平均短於正常值30厘米,即使為單側黏連之患者,其雙側下顎骨發育均受影響。下顎骨呈後旋轉致頦部後縮,其形態改變包括下緣內凹曲線明顯異常及相對患側關節窩往前下方位移。患者上顎長度亦短於正常值。上下顎間關係(ANB)平均大於正常值10°之多。但上下門齒間距平均值正常為代償性角度變的結果。此外顏面垂直高度及下上臼齒齒槽骨高度均小於正常值。 結論:顳顎關節粘連影響不只是關節本身或功能障礙,對顱顏生長之大小,方向及形態均造成顯著影響。治療目標應兼具及早恢復下顎功能與改正顱顏形態。此外針對顳顎關節和下顎外傷骨折做適當治療,妥善處理頭頸部感染,將可預防顳顎關節粘連及其伴隨之後遺症。 |
英文摘要 | Background: The sequelae of tempormanibular joint (TMJ) ankylosis include limitation of jaw movement, interference of oral function and affects on the craniofacial growth. Analysis of craniofacial form of TMJ ankylosis offers guidelines for managing this disease. Methods: Forty-five patients with intrarticular TMJ anakylosis were collected from the female patients aged 3 to 47 years. Thirty-seven patients were unilaterally affected and age. Both the medical history and onset of the disease were investigated in all patients. The pretreatment lateral cephalograms were used for analysis. The variables were compared with the Chinese norms with corresponding sex and age groups. Results: The etiology included 48.9% facial trauma history, 17.8% traumatic delivery or birth injury, 15.6% middle ear or dental infection, 2.2% chronic arthritis and 15.6% unknown causes. The onset of mouth opening limitation was under 16 years of age. The average total mandibular length was less than the norm by 30 mm. each patient presented wiuth a mandible that had backword rotation with chin recession. Accentuated antegonial notch and inferiorly lacted condlyle were observed on the affected side. The maxilla was shorter and the ANB was larger than the norm by 10° but the overbite and overjet were within normal ranges. Conclusions: The facial growth was severely disturbed in terms of dimension, morphology and direction of growth in patients with TMJ ankylosi. Better management of mandibular fractures, good infection control and early treatment intervention are ways to reduce the influence on creaniofacial growth. |
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