[Bone remodeling in patients with juvenile condylar resorption after stabilization splint treatment].

Objective: To investigate bone remodeling in patients with different types of juvenile condylar resorption after stabilization splint treatment using cone-beam CT (CBCT). Methods: Fifty-nine juvenile condylar resorption patients (114 sides of condyle) treated with stabilization splint from January 2012 to May 2018 in Department of Temporomandibular Joint, Stomatological Hospital of Chongqing Medical University were selected as splint group, while twenty-four patients (48 sides of condyle) who underwent natural remodeling without stabilization splint treatment after 6-12 months were severed as control group. Pre-and post-treatment CBCT was taken for all patients. There were three types of condyles (including type Ⅰ, type Ⅱ and type Ⅲ) before treatment and four types of condyles (including progression, no changes, stable without new bone and remodeled with new bone) after treatment. Progression and no change were considered as poor curative effect, and stable without new bone and remodeled with new bone were considered to be effective. The vertical distance of the condylar height was measured and compared before and after treatment in the two groups. Results: Significant difference in treatment outcome was found in types Ⅰ and Ⅱ between the splint group and the control group (Z=-2.874, P=0.004; Z=-3.874, P=0.000), and no significant difference was found in type Ⅲ between the two groups (Z=-0.617, P=0.537). The difference of condylar progression percentage [splint group: 43% (15/35), control group: 80% (16/20)] was statistically significant between the two groups in type Ⅱ (χ(2)=7.139, P=0.011), and no significant difference was found in types Ⅰ and Ⅲ between the two groups (χ(2)=0.103, P=0.748; χ(2)=1.249, P=0.540). In two groups, the condylar height difference before and after treatment in type Ⅱ condylar resorption was statistically significant (P<0.05). Conclusions: Stabilization splint treatment was effective in patients with different types of juvenile condylar resorption, especially in type Ⅰ. However, it was difficult to reverse the height reduction of the condylar bone regardless of treatment.目的： 通过锥形束CT影像观察稳定性■垫对青春期髁突吸收患者骨质改建的影响，分析不同类型髁突吸收的疗效，以期为临床提供参考。 方法： 选取2012年1月至2018年5月于重庆医科大学附属口腔医院颞下颌关节科就诊的青春期髁突吸收患者，以采用稳定性■垫治疗的59例患者（114侧髁突）为■垫组，以未行任何治疗并经过6~12个月自然观察期的24例患者（48侧髁突）为对照组（以观察期结束时为治疗后）。根据患者治疗前锥形束CT，将髁突吸收分为Ⅰ、Ⅱ、Ⅲ型；比较患者治疗前后锥形束CT，将治疗后髁突分为吸收进展、无变化、稳定无新骨和改建有新骨4种类型，以前两者为疗效差，以后两者为疗效好，并计算3型髁突继续吸收者占比；同时测量治疗前后髁突高度，比较两组患者治疗前后髁突高度变化。 结果： Ⅰ和Ⅱ型髁突吸收的■垫组疗效均显著好于对照组（Z=-2.874，P=0.004；Z=-3.874，P=0.000）；Ⅲ型髁突吸收的两组疗效差异无统计学意义（Z=-0.617，P=0.537）。■垫组Ⅱ型髁突继续吸收者占比[43%（15/35）]显著小于对照组[80%（16/20）]（χ(2)=7.139，P=0.011），Ⅰ、Ⅲ型髁突继续吸收者占比的两组差异均无统计学意义（χ(2)=0.103，P=0.748；χ(2)=1.249，P=0.540）。与治疗前相比，两组患者治疗后髁突高度均呈下降趋势，其中■垫组和对照组Ⅱ型髁突吸收者髁突高度的治疗前后差异均有统计学意义（P<0.05）。3种类型髁突吸收患者髁突高度治疗前后变化量的两组差异均无统计学意义（P>0.05）。 结论： 稳定性■垫治疗不同类型青春期髁突吸收有较好的治疗效果，尤其是Ⅰ型髁突吸收，可及早促进髁突骨质较好改建，但不论治疗与否髁突高度降低难以逆转。.