成人综合正畸治疗后髁突意外移位的发生率。

Hosik Jang, Ji-Hyun Lee, Tung Nguyen, Kyung-Ho Kim, Chooryung J Chung
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引用次数: 0

摘要

目的评估成人综合正畸治疗后意外/过度髁突移位的发生率和模式:在正畸队列(N = 291)中连续收集接受综合正畸治疗的成人患者(年龄≥18 岁)的治疗前(T1)和治疗后(T2)锥形束计算机断层扫描结果。将 T1 和 T2 CBCT 进行三维(3D)叠加,通过 T1 和 T2 之间髁颈点(CdN)的三维变化(ΔCdN)估算髁突位移。髁状突移位过多(ΔCdN >1毫米)的参与者被归类为髁状突移位(+),否则被归类为髁状突移位(-)。研究了髁状突移位的发生率和模式,以及与性别、年龄、骨骼关系、拔牙方式、治疗时间、颞下颌关节紊乱病史和髁状突吸收等因素的关系,并对最终的咬合结果进行了分析:结果:成人正畸队列中髁突移位大于1毫米的发生率为6.2%。女性(与男性相比;OR:9.07;[95% CI:1.19-69.23])和骨骼等级 II(与等级 I 和 III 相比;OR:4.57 [95% CI:1.58-13.20])出现意外髁突移位的几率明显更高(P < .05)。在有髁突移位的参与者中,髁突吸收并不明显,也不会影响最终的正畸结果:结论:约有 6% 的成人正畸患者的三维髁突意外移位超过 1 毫米。然而,髁突移位本身与髁突吸收无关,不会引起临床问题。
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Incidence of unexpected condylar displacement following comprehensive orthodontic treatment in adults.

Objectives: To evaluate the incidence and pattern of unexpected/excessive condylar displacement after comprehensive orthodontic treatment in adults.

Materials and methods: Adult patients (age ≥18 years) who underwent comprehensive orthodontic treatment with pre-(T1) and post-treatment (T2) cone beam computed tomography scans were consecutively collected within an orthodontic cohort (N = 291). T1 and T2 CBCTs were superimposed three-dimensionally (3D) and condylar displacement was estimated by the 3D changes of condylar neck point (CdN) between T1 and T2 (ΔCdN). Participants with excessive condylar displacement (ΔCdN >1 mm) were classified as condylar displacement (+) and otherwise as displacement (-). The incidence and pattern of condylar displacement, association with factors such as sex, age, skeletal relationship, extraction pattern, treatment duration, history of temporomandibular joint disorder, and presence of condylar resorption with the final occlusal outcome were investigated.

Results: The incidence of unexpected condylar displacement >1 mm in the adult orthodontic cohort was 6.2%. Females (vs males; OR: 9.07; [95% CI: 1.19-69.23]) and Skeletal Class II (vs Classes I and III; OR: 4.57 [95% CI: 1.58-13.20]) demonstrated significantly higher odds of unexpected condylar displacement (P < .05). Condylar resorption was not evident in participants with condylar displacement and did not interfere with the final orthodontic outcome.

Conclusions: Unexpected 3D condylar displacement exceeding 1 mm was noted in approximately 6% of the adult orthodontic patient cohort. However, the condylar displacement per se was not associated with condylar resorption and did not cause clinical concerns.

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