구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제25권3호
  • /
  • Pages.211-224
  • /
  • 2009
  • /
  • 2384-4353(pISSN)
  • /
  • 2384-4272(eISSN)
대한턱관절교합학회 (Korean Academy of Stomatognathic Function and Occlusion)
권호 표지

Cone Beam CT를 이용한 하악 과두의 골 이상에 대한 방사선적 분석

Radiographic examination of the Osseous Abnormalities of the Mandibular Condyle Using Cone Beam Computed Tomography

  • 김유진 (원광대학교 치과대학 보철학교실) ;
  • 김윤상 (원광대학교 치과대학 보철학교실) ;
  • 김민정 (원광대학교 치과대학 보철학교실) ;
  • 심헌보 (원광대학교 치과대학 보철학교실) ;
  • 오상천 (원광대학교 치과대학 보철학교실)
  • Kim, Yu-jin (Department of Prothodontics, Sanbon Dental Hospital, College of dentistry, Wonkwang University) ;
  • Kim, Yun-sang (Department of Prothodontics, Sanbon Dental Hospital, College of dentistry, Wonkwang University) ;
  • Kim, Min-jeong (Department of Prothodontics, Sanbon Dental Hospital, College of dentistry, Wonkwang University) ;
  • Sim, Hun-Bo (Department of Prothodontics, Sanbon Dental Hospital, College of dentistry, Wonkwang University) ;
  • Oh, Sang-chun (Department of Prothodontics, Sanbon Dental Hospital, College of dentistry, Wonkwang University)
  • 투고 : 2009.06.05
  • 심사 : 2009.09.25
  • 발행 : 2009.09.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구의 목적은 연령과 성별 및 CT 촬영 목적에 따른 하악 과두의 골 이상에 대한 양상과 발병률 그리고 호발 부위를 살펴보고, 촬영 목적에 있어서 TMD 진단을 위한 그룹과 그 외의 그룹간의 발병 양상을 비교해 보기 위함이다. 원광대학교 산본 치과 병원으로부터 $i-CAT^{TM}$ Cone Beam Computed Tomography를 이용하여 촬영된 199명의 3차원 CT 영상을 수집하고, 촬영된 MPR 이미지는 하악 과두의 연속된 시상 이미지와 관상 이미지를 얻기 위하여 TMJ 모드로 전환되었다. 3명의 관찰자는 이를 토대로 골 이상의 양상 및 발병률, 호발 부위, 그리고 하악 과두의 전반적인 외형에 대해 각기 독립적으로 판독한 결과 type F가 type N보다도 훨씬 흔하게 관찰 되었다. 시상 이미지에서의 호발 부위는 type D-C를 제외하고는 하악 과두의 전상방 및 상방 부위였으며, type D-C에서는 후상방 부위가 가장 흔하였다. 관상 이미지에서는 type E를 제외하고는 외상방 및 상방 부위에 호발하였으나, type E에서는 내상방 및 상방 부위에서 빈발 하였다. 하악 과두의 골 이상 소견은 type D-C를 제외하고는 TMD 진단을 위한 그룹에서 보다 높게 나타났으며, 그 외의 그룹에서는 type N 및 type D-C가 보다 높게 나타났다. 본 연구에서는, 하악 과두의 골 이상 소견을 6가지 분류해 보았으며, 이러한 골 이상 소견은 각기 빈발하는 부위가 있는 것으로 나타났다. 그리고 TMD 진단 그룹이 type D-C를 제외하고는 골 이상 소견이 더 높게 나타나는 경향을 보였다.

The objective of this study is to examine the condylar surfaces in order to find out the types, the incidence and common occurrence area of the osseous abnormalities of the condyles according to the age, genders and the purpose of CT taking, and to compare those between the groups for TMD diagnosis and the other groups. 3D CT images of 199 patients which were scanned with the $i-CAT^{TM}$ Cone Beam Computed Tomography were collected from Sanbon Dental Hospital of Wonkwang university and the MPR images were transfered to the TMJ mode to be showed serial sagittal images and coronal images. The images were macroscopically examined by three independent observers for the types and incidences of the osseous abnormalities, their common occurrence area and general shapes of the condyles. As a result, type F is most common ever than type N. The common occurrence area in sagittal images is antero-superior and superior area except for type D-C which were showed on postero-superior area commonly. In coronal images, latero-superior and superior area is most common except for type E which were present on mesio-superior and superior area most frequently. The osseous abnormalities of the condyles are more common in TMD diagnosis group except for type D-C, that is type N and type D-C are more common in the other groups. In this study, abnormalities of the condyles are classified into 6 types and it has a common occurrence area each. And TMD diagnosis group shows a tendency to have higher rate for osseous abnormalities except for type D-C.

키워드

참고문헌

  1. Preda L, Di Maggio EM, Dore R, La Fianza A, Solcia M. Schifino MR, et al. Use of spiral computed tomography for multiplanar dental reconstruction. Dentomaxillofac Radiol 1997;26:327-331 https://doi.org/10.1038/sj.dmfr.4600290
  2. Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IA, A new volumetric CT machine for dental imaging based on the cone-beam technique: preliminary results. Eur Radiol 1998;8:1558-1564 https://doi.org/10.1007/s003300050586
  3. Cohnen M, Kemper J, M$\ddot{o}$bes O, Pawelzik J, M$\ddot{o}$dder U. Radiation dose in dental radiology. Eur Radiol 2002;12:634-637 https://doi.org/10.1007/s003300100928
  4. Parks ET. Computed tomography application for dentistry. Dent Clin North Am 2000;44:371-394
  5. Cavalcanti MG, Ruprecht A. Vannier MW. 3D volume rendering using multislice CT for dental implants. Dentomaxillofac Radiol 2002;31: 218-223 https://doi.org/10.1038/sj.dmfr.4600701
  6. de Bont LG, van der Kuijl B. Stegega B, Vencken LM, Boering G. Computed tomography in differential diagnosis of temporomandibular joint disorders. Int J Oral Maxillofac Surg 1993;22:200-209 https://doi.org/10.1016/S0901-5027(05)80636-8
  7. Ylikontiola L, Moberg K, Huumonen S, Soikkonen K, Oikarinen K. Comparison of three radiographic mehtods used to locate the mandibular canal in the buccolingual direction before bilateral sagittal split osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:736-742 https://doi.org/10.1067/moe.2002.122639
  8. Westesson P, Katzberg R W, Tallents R H, Sanchez-Woodworth R E, Svensson S A. CT and MR of the Temporomandibular Joint : Comparison with Autopsy Specimens. Am J Radiol 1987;148: 1165-1171 https://doi.org/10.2214/ajr.148.6.1165
  9. Manbzione J V, Sanchez-Woodwoth R E, Katzberg R W, Cohen B D, Tallents R H, Macher D, Bessette R W. Magnetic resonance imaging of the temporomandibular joint. J Am Dent Assoc. 1986; 113:398-402 https://doi.org/10.14219/jada.archive.1986.0196
  10. K Honda, TA Larheim, K Maruhashi, K matsumoto, K Iwai. Osseous abnormalities of the mandibular condyle: diagnostic reliability of cone beam computed tomography compared with helical computed tomography based on autopsy material. Dentomaxillofacial Radiology 2006;35:152-157 https://doi.org/10.1259/dmfr/15831361
  11. Hussain A, Packota G, Major P, Flores-Mir C. Role of different imaging modalities in assessment of temporomandibular joint erosions and osteophytes : a systematic review. Dentomaxillofacial Radiology 2008;37:63-71 https://doi.org/10.1259/dmfr/16932758
  12. Oana Bida Honey, William Charles Scarfe, Michael J. Hilgers, Kathleen Klueber, Anibal M. Silveira, Bruce S. Haskell, and Allan G. Farman. Accuracy of cone-beam computed tomography imaging of the temporomandibular joint: Comparisons with panoramic radiology and linear tomography. Am J Orthod Dentofacial Orthop 2007;132: 429-38 https://doi.org/10.1016/j.ajodo.2005.10.032
  13. Hintze H, Wiese M, Wenzel A. Cone beam CT and conventional tomography for the detection of morphological temporomandibular joint changes. Dentomaxillofacial Radiology 2007;36:192-197 https://doi.org/10.1259/dmfr/25523853
  14. CA Lascala, J Panella and Marques. Analysis of the accuracy of linear measurements obtained by cone beam computed tomography (CBCT-NewTom). Dentomaxillofacial Radiology 2004;33:291-294 https://doi.org/10.1259/dmfr/25500850
  15. Brian Schlueter, Ki Beom Kim, Donald Oliver, Gus Sortiropoulos. Cone Beam Computed Tomography 3D Reconstruction of the Mandibular Condyle. Angle Orthodontist. Vol 78,No 5,2008
  16. K Tsiklakis, K Syriopoulos, HC Stamatakis. Radiographic examination of the temporomandibular joint using cone beam computed tomography. Dentomaxillofacial Radiology 2004;33:196- 201 https://doi.org/10.1259/dmfr/27403192
  17. Kim SY, Han JW, Park IW. Comparison of cone beam CT and conventional CT in absorbed and effective dose. Korean J Oral Maxillofac Radiol 2008;38:7-15
  18. Kim KA, Koh KJ. Positional relationship between the maxillary sinus floor and the apex of the maxillary first molar using cone beam computed tomograph. Korean J Oral Maxillofac Radiol 2008;38:95-101
  19. Lee BH. Positional change of the condylar heads after wearing complete denture on dental cone beam CT. Korean J Oral Maxillofac Radiol 2008;38:23-27
  20. Uemura S. Nakamura M, Iwasaki H, Fuchihata H. A roentgenological study on temporomandibular joint disorders. Morphological changes of TMJ arthrosis. Dent Radiol 1979;19: 224-237. (In japanese)
  21. J Koyama, H Nishiyama, T Hayashi. Follow-up study of condylar bony changes using helical computed tomography in patients with temporomandibular disorder. Dentomaxillofacial Radiology 2007;36: 472-477 https://doi.org/10.1259/dmfr/28078357
  22. Laurell K A, Tootle R, Cunningham R, Bertran J, Simon D. Magnetic resonance imaging of the temporomandibular joint. Part I ; Literature review. J Prosthet Dent 1987;58:83-289 https://doi.org/10.1016/S0022-3913(87)80149-X
  23. Brooks SL, Westesson PL, Ericksson L, Hansson LG, Barsotti JB. Prevalence of osseous changes in the temporomandibular joint of asymptomatic persons without internal derangement. Oral Surg Oral Med Oral Pathol 1992;73:118-122 https://doi.org/10.1016/0030-4220(92)90168-P
  24. Yong-Kyu Lim, Min-Ji Kim, Youn-Joong Kim, Yun-Heon Song, Dong-Yul Lee. Distribution and clinical features of patients with degenerative change of the mandibular condyle. Korea J Orthod 2006;36(6):402-11
  25. Yale S H, Ceballos M, Kresnoff C S, Hauptfuehrer J D. Some observations of the classification of mandibular condyle types. Oral Surg 1963;16: 572-577 https://doi.org/10.1016/0030-4220(63)90146-4
  26. Sung-Bok Lee, Dae-Gyun Choi, Boo-Byung Choi. A comparative study on magnetic resonance image and sectograph of human TMJ. The Journal of Korean Academy of Prosthodontics. 1993;31:249- 270