Twin-Block矫治器前导下颌后颞下颌关节稳态重建的锥形束计算机断层扫描三维分析

doi:10.3969/j.issn.1006-7795.2025.06.009

首都医科大学学报 ›› 2025, Vol. 46 ›› Issue (6): 1019-1025.doi: 10.3969/j.issn.1006-7795.2025.06.009

Twin-Block矫治器前导下颌后颞下颌关节稳态重建的锥形束计算机断层扫描三维分析

车成娜^#，刘冠邑^#，李德水，任慧颖，于静怡，魏福兰^*

山东大学齐鲁医学院口腔医学院·口腔医院正畸科山东省口腔组织再生重点实验室口腔生物材料与组织再生山东省工程研究中心山东省口腔疾病临床医学研究中心, 济南 250012

收稿日期:2025-09-08 修回日期:2025-10-03 出版日期:2025-12-21 发布日期:2025-12-19
通讯作者: 魏福兰 E-mail:weifl@email.sdu.edu.cn

Three-dimensional cone-beam computed tomography analysis of temporomandibular joint steady-state reconstruction following twin-block appliance-induced mandibular advancement

Che Chengna, Liu Guanyi, Li Deshui, Ren Huiying, Yu Jingyi, Wei Fulan

Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China

Received:2025-09-08 Revised:2025-10-03 Online:2025-12-21 Published:2025-12-19

摘要/Abstract

摘要： 目的拟利用锥形束计算机断层扫描（cone-beam computed tomography, CBCT）三维重建分析Twin-Block矫治器前导下颌建立颞下颌关节新稳态后形态结构的三维变化。方法选取15例2023年6月至2025年7月就诊于山东大学口腔医院正畸科并采用Twin-Block矫治器治疗的青少年患者。收集患者治疗前、后的CBCT图像，使用Mimics 21.0软件对颞下颌关节进行三维重建，并在三维模型上对髁突形态、关节间隙进行标志点定位与数据测量，对治疗前、后测量数据进行统计学分析。结果与治疗前相比，治疗后髁突内外径、髁突前后径、髁突高度、髁突表面积、髁突体积及髁突头体积增加（P<0.05）；关节上间隙增宽（P<0.05）；治疗前后髁突前后位置发生改变。结论采用Twin-Block矫治器前导下颌后，髁突发生生长改建，髁突高度、体积及表面积增大，髁突相对关节窝向前、向下发生移位。颞下颌关节在新的前导位置实现了结构与功能相协调的平衡状态。

关键词: Twin-Block矫治器, 前导下颌, 颞下颌关节, 稳态重建, 三维重建分析, 锥形束计算机断层扫描

Abstract: Objective To analyze the three-dimensional(3D) changes of the morphology and structure of the temporomandibular joint (TMJ）after the establishment of a new steady-state through Twin-Block-induced mandibular advancement with 3D reconstruction of cone beam computed tomography (CBCT). Methods Fifteen adolescent patients treated with Twin-Block appliances at the Department of Orthodontics, Shandong University School of Stomatology from June 2023 to July 2025 were selected. Pre- and post-treatment CBCT images were collected. Mimics 21.0 software was utilized for 3D reconstruction of the TMJs. Landmark identification and data measurement of condylar morphology and joint space were performed on the 3D models. Statistical analysis of pre- and post-treatment measurements was conducted. Results Compared with pre-treatment values, significant increases were observed in post-treatment condylar mediolateral dimension, anteroposterior dimension, height, surface area, total volume, and head volume (P<0.05). The superior joint space was significantly widened (P<0.05), and positional changes of the condyle were detected. Conclusion Twin-Block mandibular advancement therapy induced adaptive growth remodeling of the condyle, characterized with increased height, volume and surface area, along with anterior and inferior displacement of the condyle relative to the glenoid fossa. The temporomandibular joint achieved a balanced state of structural and functional coordination at the new leading position.

Key words: Twin-Block appliance, mandibular advancement, temporomandibular joint, steady-state reconstruction, three-dimensional reconstruction analysis, cone-beam computed tomography

中图分类号:

R783.5

车成娜, 刘冠邑, 李德水, 任慧颖, 于静怡, 魏福兰. Twin-Block矫治器前导下颌后颞下颌关节稳态重建的锥形束计算机断层扫描三维分析[J]. 首都医科大学学报, 2025, 46(6): 1019-1025.

Che Chengna, Liu Guanyi, Li Deshui, Ren Huiying, Yu Jingyi, Wei Fulan. Three-dimensional cone-beam computed tomography analysis of temporomandibular joint steady-state reconstruction following twin-block appliance-induced mandibular advancement[J]. Journal of Capital Medical University, 2025, 46(6): 1019-1025.

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Twin-Block矫治器前导下颌后颞下颌关节稳态重建的锥形束计算机断层扫描三维分析

Three-dimensional cone-beam computed tomography analysis of temporomandibular joint steady-state reconstruction following twin-block appliance-induced mandibular advancement

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