单侧后牙正锁𬌗、反𬌗对下颌升支及髁突对称性影响的临床观察

doi:10.3969/j.issn.1005-4979.2020.06.007

摘要/Abstract

摘要：

目的：通过对正锁𬌗、反𬌗患者与磨牙中性关系者进行比较，探究其是否对下颌骨对称性发育有影响。方法：选取87例正畸患者的全景X线片资料，进行下颌不对称性测量。将患者分为对照组（28例）、反𬌗组（23例）及正锁𬌗组（36例），对各组男性与女性下颌升支、髁突及下颌高度不对称指数进行统计学分析。结果：患者年龄与下颌骨对称性无关；正锁𬌗组男性与女性髁突对称性指数差异存在统计学意义（P<0.05）。3组间的下颌升支、下颌高度不对称指数差异无统计学意义（P>0.05），而对照组与正锁𬌗组髁突不对称指数的差异存在统计学意义。结论：单侧正锁𬌗可引起患者髁突的不对称，临床上需引起重视。

关键词: 正锁牙合, 反牙合, 颞下颌关节, 髁突, 对称性

Abstract:

Objective: To investigate the effect of the scissors bite and crossbite occlusion on the symmetric development of the mandible. Methods: The mandibular asymmetry was measured by the panoramic X-ray images of 87 orthodontic patients. The patients were divided into control group(n=28), crossbite group(n=23) and scissors bite group(n=36). The data of ascending ramus, condylar process, and asymmetric index of mandibular height were analyzed statistically. Results: It showed that age had nothing to do with the symmetry of mandible, but the gender was significantly different in the symmetry index of condylar process in the scissors bite group（P<0.05）. There was no statistical difference in mandibular ramus and asymmetric index of mandibular height between the control group, the scissors bite group and the crossbite group, while there was a statistical difference in the asymmetry of condylar process between the control group and the scissors bite group. Conclusion: Patients with unilateral scissors bite can cause the asymmetry of the condyle which needs to be paid more attention in clinical practice.

Key words: scissors bite, crossbite, temporomandibular joint, condyle, symmetry

叶莉娜, 何家才. 单侧后牙正锁𬌗、反𬌗对下颌升支及髁突对称性影响的临床观察[J]. 《口腔颌面外科杂志》, 2020, 30(6): 382-386.

YE Lina, HE Jiacai. Clinical Observation of the Effect of Unilateral Posterior Scissors-bite and Crossbite on the Symmetry of Mandibular Ramus and Condyle[J]. 《Journal of Oral and Maxillofacial Surgery》, 2020, 30(6): 382-386.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2020/V30/I6/382

图/表 9

表1 患者年龄分布（例）

Table 1 Age distribution of patients （case）

组别	性别	年龄/岁			总计
组别	性别	12~14	15~18	>18	总计
对照组	男	3	2	6	11
	女	4	2	11	17
反𬌗组	男	3	4	5	12
	女	1	5	5	11
正锁𬌗组	男	4	5	7	16
	女	4	5	11	20

图1 Habets测量法示意图注：A. 下颌升支最外侧点；B.髁突最外侧点；C. 髁突最高点；D. C到AB连线的垂足。

Figure 1 Schematic diagram of Habets measurement

表2 各组下颌升支、髁突、下颌高度不对称指数比较

Table 2 Comparison of asymmetry index of mandibular ascending ramus, condyle and mandibular height in each groups

相关指数	P
相关指数	对照组	反𬌗组	正锁𬌗组
下颌升支不对称指数	0.452	0.507	0.856
髁突不对称指数	0.746	0.278	0.022^*
下颌高度不对称指数	0.723	0.812	0.755

表3 各组下颌升支、髁突、下颌高度不对称指数方差齐性检验概率值

Table 3 Homogeneity of variance test of asymmetry index of mandibular ascending ramus, condyle and mandibular height in each group

	男	女
下颌升支不对称指数	0.280	0.914
髁突不对称指数	0.048^*	0.005^*
下颌高度不对称指数	0.569	0.312

表4 3组男性下颌升支、下颌高度不对称指数单因素方差分析

Table 4 One-way ANOVA of asymmetry index of mandibular ascending ramus and mandibular height in 3 male groups

	对照组		反𬌗组		正锁𬌗组		P
	平均值	标准差	平均值	标准差	平均值	标准差	P
下颌升支不对称指数	0.030	0.042	0.027	0.020	0.018	0.013	0.484
下颌高度不对称指数	0.025	0.038	0.020	0.019	0.019	0.016	0.812

表5 3组髁突高度不对称指数Kruskal-Wallis检验

Table 5 Kruskal-Wallis test for asymmetry index of condyle height in 3 groups

		对照组		反𬌗组		正锁𬌗组		P
		平均值	标准差	平均值	标准差	平均值	标准差	P
髁突高度	男	0.030	0.022	0.064	0.055	0.112	0.045	0.000^**
不对称指数	女	0.034	0.032	0.103	0.106	0.076	0.044	0.002^**

表6 3组男性髁突高度不对称指数Mann-Whitney检验

Table 6 Mann-whitney test for asymmetry index of condyle height in 3 male groups

	对照组	反𬌗组	正锁𬌗组
对照组	-	-	-
反𬌗组	0.190	-	-
正锁𬌗组	0.000^**	0.023	-

表7 3组女性下颌升支、下颌高度不对称指数单因素方差分析

Table 7 One-way ANOVA of asymmetry index of mandibular ascending ramus and mandibular height in 3 female groups

	对照组		反𬌗组		正锁𬌗组		P
	平均值	标准差	平均值	标准差	平均值	标准差	P
下颌升支不对称指数	0.021	0.016	0.022	0.015	0.017	0.018	0.665
下颌高度不对称指数	0.021	0.014	0.023	0.025	0.017	0.014	0.626

表8 3组女性髁突高度不对称指数Mann-Whitney检验

Table 8 Mann-whitney test for asymmetry index of condyle height in 3 female groups

	对照组	反𬌗组	正锁𬌗组
对照组	-	-	-
反𬌗组	0.020^*	-	-
正锁𬌗组	0.000^**	0.869	-

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