成人三维髁突亚型分型及其与阻塞性睡眠呼吸暂停严重程度的关联：对颅面骨骼表型的意义
Three-Dimensional Condylar Subtyping and Its Association With Obstructive Sleep Apnea Severity in Adults: Implication for Craniofacial Skeletal Phenotype.
文献信息
| PMID | 42983947 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Min-Ji Jeon |
| 作者单位 | Department of Orthodontics, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, Seoul, Republic of Korea. |
| 期刊 | Journal of oral rehabilitation |
| SCI 分区 | Q1 |
| IF | 3.8 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 探讨成人三维（3D）髁突吸收模式与阻塞性睡眠呼吸暂停（OSA）严重程度之间的关联，并在颅面骨骼表型（CSP）框架内探讨其结构意义。
方法： 采用整合吸收程度与皮质重塑模式的双轴系统对髁突形态进行分类。患者被分为无吸收（NR）、适应性重塑（AR）和严重吸收（SR）组。比较各组间的牙颌骨骼、颞下颌关节（TMJ）及多导睡眠监测变量。多变量回归分析校正年龄、性别和体重指数，并采用分层回归检验髁突分组在CSP之外的贡献。
结果： 样本中23.9%存在严重髁突吸收，且在具有CSP特征的患者中更为常见（54.0%）。SR组表现出更大的骨骼差异以及更高的呼吸暂停低通气指数（AHI）、呼吸紊乱指数（RDI）和觉醒指数（ArI）值（均p < 0.05）。在校正年龄、性别和体重指数并进行错误发现率校正后，SR仍与较高的AHI、RDI和ArI显著相关，而TMJ疼痛史、髁突角度和氧合相关指标未见显著关联。在分层模型中，经多重检验校正后，髁突分组在CSP之外的整体增量贡献不显著；然而，在进一步校正CSP后，SR仍与较高的AHI和RDI显著相关（两者FDR校正p = 0.045）。
结论： 严重髁突吸收与更大的骨骼差异和更高的OSA负担相关。三维TMJ评估可能补充成人OSA的常规骨骼表型分析。
英文摘要
OBJECTIVES: To investigate the association between three-dimensional (3D) condylar resorption pattern and obstructive sleep apnea (OSA) severity in adults, and to explore its structural implications within the craniofacial skeletal phenotype (CSP) framework.
METHODS: Condylar morphology was classified using a two-axis system integrating the degree of resorption and cortical remodelling pattern. Patients were grouped into no resorption (NR), adaptive remodelling (AR), and severe resorption (SR) categories. Dentoskeletal, temporomandibular joint (TMJ), and polysomnographic variables were compared among groups. Multivariable regression analyses were adjusted for age, sex, and body mass index, and hierarchical regression was used to examine the contribution of condylar grouping beyond CSP.
RESULTS: Severe condylar resorption was identified in 23.9% of the sample and was more prevalent (54.0%) in patients with CSP features. The SR group demonstrated greater skeletal discrepancy and higher apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and arousal index (ArI) values (all, p < 0.05). After adjustment for age, sex, and body mass index and false discovery rate correction, SR remained significantly associated with higher AHI, RDI, and ArI, whereas TMJ pain history, condylar angulation, and oxygenation-related indices showed no significant associations. In hierarchical models, the overall incremental contribution of condylar grouping beyond CSP was not significant after multiple-testing correction; however, SR remained significantly associated with higher AHI and RDI after additional adjustment for CSP (both, FDR-adjusted p = 0.045).
CONCLUSIONS: Severe condylar resorption was associated with greater skeletal discrepancy and higher OSA burden. Three-dimensional TMJ assessment may complement conventional skeletal phenotyping in adult OSA.