经颧弓后上牵引下颌后关节盘后区适应性改建的实验研究  

An experimental study of the remodeling mechanism of the retrodiscal tissues by traction of the mandibular ramus and zygomatic arch in rabbits

作　　者：许小会[1] 吴凤鸣[1] 陈盛[1] 刘来奎[1] 

机构地区：[1]南京医科大学口腔医学研究所.南京医科大学口腔医学院,210029

出　　处：《实用口腔医学杂志》2009年第6期774-778,共5页Journal of Practical Stomatology

基　　金：江苏省自然科学基金项目资助(编号:BK2008362);江苏省卫生厅科研项目(编号:H200753)

摘　　要：目的:观察经颧弓后上牵引兔下颌后颞下颌关节盘后区是否发生适应性改建及其意义。方法:在兔下颌角和颧弓处打孔后放置牵引装置,向后上方牵引下颌,于术后2、4、6周分别处死动物,采用组织学及免疫组化方法观察负荷下关节盘后区组织的改变。结果:术后2周兔牵引侧关节盘移位或变形,盘后区胶原密度增加;随着负荷时间的延长,关节后区成纤维细胞密度明显下降,关节盘后区结缔组织变得致密,组织内出现少量软骨样细胞出现,而对照组标本未见明显组织学改变。与对照组相比,术后2周移位的关节盘功能区软骨基质、蛋白聚糖及Ⅱ型胶原呈弱表达,阿辛蓝染色变淡;移位至负重区的关节盘后区软骨基质、蛋白聚糖表达比对照组有所增加。随着关节负荷时间的延长,移位至负重区的关节盘后区软骨基质、蛋白聚糖及Ⅱ型胶原逐渐增强。结论:经颧弓后上牵引下颌后,关节盘后区组织内软骨基质合成增加,并有少量软骨细胞出现,发生改建以适应关节功能。Objective： To investigate the remodeling mechanism of the retrodiscal tissues of temporomandibular joint after mechanical loading. Methods： 15 adult New Zealand rabbits were subjected to traction between the mandibular ramus and zygomatic arch in the postero-superior direction unilaterally using elastic force. The animals were killed respectively at 2, 4 and 6 weeks. The histologic features were observed by Hematoxylin ＆ Eosin and Alcian blue staining. The expressions of aggre can and collagen Ⅱ antigen in the articular disc of temporomandibular joint were observed by immunohistochemical staining. Results： The articular disc of the traction side in temporomandibular joint was characterized by an early phase （2 weeks postoperatively）with partial anterior disc displacement and disc deformity and subsequently in deposition of fibrous material in the matrix of the retrodiscal tissues. With time going on, fibroblasts significantly decreased and connective tissues increased. A small quantity of cartilage-like cells were also investigated in that area. However, no obvious histological change was observed in the control group. Compared with the control group, glycosaminoglycan, ag- grecan and collagen Ⅱ were weakly positive in the intermediate zone of articular disc in experimental group. Aggrecan was stronger positive in the intermediate zone of articular disc after two weeks in experimental group. When traction period prolonged, glycosaminoglycan, aggrecan and collagen Ⅱ were strong positive in the retrodiscal tissue of articular disc in experimental group. Conclusion： These investigations reveal that distracting mandibule towards rear and top through ansa capitis, the synthesis of cartilage matrix increase and a small quantity of cartilage cells appear to adjust to its functions.

关 键 词：颞下颌关节 关节盘 改建 

分 类 号：R782.6[医药卫生—口腔医学] R783.5[医药卫生—临床医学]