| Part 1 Study on the relationship between temporomandibular joint space change and disc displacement.Objective Study the relationship between temporomandibular joint space change and disc displacement by magnetic resonance imaging(MRI)and cone-beam computed tomography(CBCT),providing reference for clinical diagnosis of disc displacement.Methods In this study,108 patients with temporomandibular joint disorders underwent MRI examination of temporomandibular joint at Zhejiang Aibo Medical Imaging Diagnostic Center from January to December 2021.Thirty of them underwent CBCT examination of the temporomandibular joint in the Affiliated Stomatological Hospital of Zhejiang Chinese Medicine University before.The 216 joints included in the study were divided into five groups according to disc displacement degree,expressed by disc boundary Angle,group A(no disc displacement):-15°～15°;group B(mild anterior disc displacement):16°～50°;group C(moderate anterior disc displacement):51°～80°;group D(severe anterior disc displacement):≥81°;group E(retroarticular disc displacement):≤-16°.The 132 joints of anterior disc displacement were divided into group anterior disc displacement with reduction(ADDwR)and anterior disc displacement without reduction(ADDwoR)according to displacement type.Joint Spaces were measured on CBCT and MRI images using AutoCAD software,and ln(P/A)values were calculated.The final data was imported into SPSS 22.0 for statistical analysis.Paired t test was used to analyze the consistency of joint space measured by CBCT and MRI.The relationship between joint space and disc displacement was studied by variance analysis.Results 1.There was no statistical significance in the joint space measured by CBCT and MRI(P>0.05).2.The anterior joint space in groups B and C was larger than that in group A,and the ln(P/A)value was smaller than that in group A,with statistical significance(P<0.05).The postarticular space of group E was larger than that of group A,and the ln(P/A)value was larger than that of group A,with statistical significance(P<0.05).There were no significant differences in joint space and ln(P/A)value between group D and group A(P>0.05).3.The anterior articular space of group ADDwR was larger than that of group A,and the ln(P/A)value was smaller than that of group A,with statistical significance(P<0.05).There were no significant differences in joint space and ln(P/A)value between group ADDwoR and group A(P>0.05).Conclusion 1.The joint Spaces detected by CBCT and MRI were consistent.2.There is a certain correlation between the change of anterior and posterior joint space and the displacement of joint disc.However,it is not possible to simply observe the joint space by CBCT to infer the displacement of the joint disc in clinical practice,so it is necessary to combine MRI and clinical examination to make a definite diagnosis.Part 2 Study on the relationship between disc morphology,joint effusion,condyle degeneration and the degree and type of disc displacementObjective MRI was used to study the relationship between the disc morphology,joint effusion,condyle degeneration and the degree and type of disc displacement,so as to assist the clinical better assessment of the condition of TMD patients and provide reference for the clinical treatment of TMD.Methods The 132 joints of anterior disc displacement in Part 1 were included in the study.They were divided into group B,C and D according to disc displacement degree,and group ADDwR and group ADDwoR according to disc displacement type.Disc morphology,joint effusion and condyle degeneration were evaluated on MRI images.Chi-square and Fisher test were used to evaluate the relationship between the disc morphology,joint effusion,condyle degeneration and the degree and type of disc displacement.Results 1.There were statistical differences in the distribution of ADDwR and ADDwoR in groups B,C and D(P<0.05).2.There were statistically significant differences in disc morphology,joint effusion and condylar bone change in group B,C and D(P<0.05),but there were no statistically significant differences in the clinical stages of condylar bone change(P>0.05).3.There were significant differences in disc morphology,joint effusion and condylar bone change between group ADDwR and ADDwoR(P<0.05),but there were no significant differences in clinical stages of condylar bone change(P>0.05).Conclusion 1.The degree of disc displacement increases and the possibility of irreversible disc displacement increases.The degree of disc displacement can be used as a reference index to evaluate whether the disc can be reduced naturally.2.The disc morphology,joint effusion and condyle degeneration were related to the degree and type of disc displacement.However,there was no significant correlation between the clinical stages of condylar bone change and the degree and type of disc displacement.Clinically,imaging findings such as disc morphology,joint effusion and condyle degeneration can be used to assist in evaluating the condition and prognosis of TMD disc displacement. |
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