间接性颞颌关节损伤后滑液中前列腺素E2含量的变化和意义

目的：通过测定间接性羊颞颌关节（TMJ）损伤后TMJ滑液中前列腺素E2（PGE2）含量的变化,探讨内源性PGE2在TMJ损伤后导致TMJ骨关节病过程中的作用。方法：用自制撞击装置间接性造成25只山羊双侧颞颌关节损伤,分别于伤后2h、7d、1个月、3个月取材,抽取关节液。以正常TMJ滑液中PGE2含量作为对照,用放射免疫法进行测定,并进行组织学观察。结果：羊TMJ损伤后TMJ 滑液中PGE2含量明显高于正常对照组,伤后关节出现了骨关节病的组织病理变化。结论：内源性PGE2在TMJ损伤后导致TMJ骨关节病过程中起重要作用。     

间接性颞颌关节损伤后滑液中前列腺素E2含量的变化和意义

目的通过测定间接性羊颞颌关节(TMJ)损伤后TMJ滑液中前列腺素E2(PGE2)含量的变化,探讨内源性PGE2在TMJ损伤后导致TMJ骨关节病过程中的作用.方法用自制撞击装置间接性造成25只山羊双侧颞颌关节损伤,分别于伤后2h、7d、1个月、3个月取材,抽取关节液.以正常TMJ滑液中PGE2含量作为对照,用放射免疫法进行测定,并进行组织学观察.结果羊TMJ损伤后TMJ滑液中PGE2含量明显高于正常对照组,伤后关节出现了骨关节病的组织病理变化.结论内源性PGE2在TMJ损伤后导致TMJ骨关节病过程中起重要作用.     

颞下颌关节紊乱综合征患者关节液中前列腺素E_2的研究

前列腺素Ｅ２（ＰＧＥ２）是与颞下颌关节紊乱综合征（ＴＭＪＤＳ）相关的主要炎症介质。本研究选用临床上诊断为ＴＭＪＤＳ患者３０例，正常对照组５例，采用放射免疫法检测ＴＭＪ关节液中ＰＧ２水平，并经统计学处理。结果表明：ＴＭＪＤＳ患者关节液中ＰＧＥ２水平明显高于正常对照组，并且ＰＧＥ２的水平与ＴＭＪＤＳ病变程度密切相关。提示ＰＧＥ２在ＴＭＪＤＳ的发生、发展中起重要作用。     

颞颌关节间接性损伤后不同时期X线表现及其意义

目的：研究山羊颞颌关节（TMJ）间接性损伤后关节结构的变化。方法：用自制撞击装置造成山羊双侧颞颌关节间接性损伤,分别于伤后2h、7d、1月、3月行X线断层摄影后处死材料,并进行组织学观察,正常关节作为对照。结果：X线断层摄片发现,TMJ损伤后关节腔模糊,腔隙缩小,髁突表面不平,结构不清,其位置由颞下凹正中逐渐偏向后。组织学观察发现,伤后早期1月内关节组织分别出现关节凹髁突表面纤维软骨破坏,关节盘纤维组织挫裂,关节腔内出现血肿等;晚期3月出现髁突表面软骨组织破坏、吸收,关节盘严重扭曲、变形。结论：一定程度的TMJ损伤可以导致TMJ内紊乱和TMJ骨关节病等后遗症的发生。X线断层摄技术是一种较好的动态观测TMJ结构和形态变化的方法。     

颞下颌关节间接性损伤后MRI表现及其意义

目的：研究羊颞下颌关节（TMJ）间接性损伤后关节结构的变化。方法：用自制撞击装置造成山羊双侧颞颌关节间接性损伤,分别于伤后2h、7h、1月、3月行MRI观察后处死取材,并进行组织学观察,正常关节作为对照,结果：TMJ损伤后MRI观察发现：TMJ间接性损伤后可导致关节软、硬组织结构的变化。在损伤早期1月内表现为髁突表面软骨的碎裂,关节盘挫裂和移位,关节间隙的减小和关节腔内出现血性渗液;在损伤后期1-3月表现为髁突表面软骨的破坏和吸收,关节盘畸形,关节间隙减小,结论：MRI不但能够清楚、全面地反映关节损伤后软、硬组织结构和形态的变化,还是一种可用于研究TMJ损伤后转归和后遗症发生机理的较好的、精确的观察手段。     

间接性颞颌关节损伤后的扫描电镜观察

目的：观察颞颌关节间接性损伤后，局部超微结构改变。方法：以１０ｍ／ｓ的撞击速度、撞击能量为１０Ｊ、方向平行于下颌角—颞下凹撞击５只山羊右侧下颌角部，伤后１月处死动物，扫描电镜观察关节盘及髁突形态的改变。左侧关节为对照。结果：损伤侧髁突和关节盘表面的凝胶样物质被破坏，暴露出下面疏松的、排列紊乱的胶原原纤维组织。结论：间接性ＴＭＪ损伤使具有抗原性的髁突表面纤维暴露，激发了抗原—抗体反应，引起关节自身破坏，导致颞下颌关节骨关节病的发生。     

局部激素注射治疗间接性颞颌关节损伤的疗效评价

目的　探讨强的松龙治疗间接性颞颌关节损伤的效果。方法　用自制撞击装置间接性造成 10只山羊双侧颞颌关节损伤 ,分别于伤后 2 h、7天向右侧关节腔内注射强的松龙液 12 .5 mg,同时向左侧关节腔内注射生理盐水作为对照 ,伤后 3月取材。印度墨汁染色后 ,通过体视显微镜和组织学方法进行观察。结果　实验侧关节的组织损害较对照侧明显减轻。结论　强的松龙颞颌关节腔内注射可减轻间接性羊颞颌关节损伤后的组织损害。     

间接性颞下颌关节损伤

本文就间接性ＴＭＪ损伤的病因，病理，诊断，治疗作一系统综述。     

颞下颌关节间接性损伤后转归及其机理

颌面部损伤常问接造成颞下颌关节损伤,如不及时治疗,可引起颞下颌关节内紊乱(TMJID)、颞下颌关节骨关节病(TMJOA)及颞下颌关节纤维性或骨性强直等后遗症的发生。本文就间接性TMJ损 伤后的转归,及导致并发症的机理,TMJ损伤与TMJID和TMJOA之间的关系做一系统综述。     

间接性颞下颌关节损伤后局部骨形成蛋白的表达及其意义

目的观察间接性颞下颌关节（TMJ）损伤后局部骨形成蛋白（BMP）的表达，探讨关节损伤与颞下颌关节骨关节病（TMJOA）的关系。方法用自制撞击装置间接造成羊右侧关节损伤，左侧关节为对照。伤后2h、一、三、六月取材，通过免疫组化的方法，利用BMP单克隆抗体观察伤后TMJ组织中BMP的表达。结果TMJ伤后早期BMP表达增强，后期BMP表达明显减弱。结论TMJ损伤导致TMJOA的机理是由于损伤破坏了髁突表面屏障。破坏和抑制了软骨的增殖能力，导致TMJOA。     

间接性颞下颌关节损伤后IL-8的表达及其意义

目的：通过观察羊颞下颌关节（TMJ）间接创伤后不同时期髁突软骨中IL-8的表达，探讨IL-8在TMJ创伤后导致TMJ骨关节病过程中的作用。方法：用自制撞击装置造成山羊双侧颞颌关节间接性创伤，分别于伤后2h,7d,1月，3月取材，并以正常TMJ作为对照，用免疫组化法进行观察。结果：TMJ创伤后髁突软骨中IL-8的表达明显强于正常对照组，其着色程度越靠近结构破坏区越明显。结论：IL-8在TMJ创伤后导致TMJ骨关节病过程中起重要作用。     

Management of the temporomandibular joint in rheumatoid disorders

This article summarises the rheumatoid diseases that particularly affect the temporomandibular joint (TMJ): psoriatic arthropathy, ankylosing spondylitis, and rheumatoid arthritis. Management is by a joint approach between rheumatologists and maxillofacial surgeons with a specific interest in diseases of the TMJ who give early surgical advice. Steroid injections, whilst useful in the short term, are not useful for long term or repeated treatment, and may lead to collapse of the joint and development of a deformed anterior open bite. These disorders should be managed primarily using standard conservative regimens, and failure to respond should lead to diagnostic or therapeutic arthroscopy and appropriate surgical treatment. When ankylosis develops or the joint collapses, a replacement joint should be considered and patients should be referred to an appropriately trained surgeon.     

Identification of prostaglandin E2 and leukotriene B4 in the synovial fluid of painful, dysfunctional temporomandibular joints

It has been hypothesized that prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) should be present in the synovial fluid of inflamed, dysfunctional temporomandibular joints. An assay to identify PGE2 and LTB4 and platelet-activating factor (PAF) was used, and a strong correlation between the levels of these lipid mediators of pain and inflammation and an index of clinical joint pathology was found.     

The effect of indirect trauma on the rat temporomandibular joint

The effect of indirect trauma to the rat temporomandibular joint (TMJ) is analysed by means of an experimental model. The trauma, applied from an angle-glenoid fossa direction, produced injury of the TMJ. The histological data demonstrated that the impact could produce fractures of the glenoid fossa, but no hemarthrosis was observed. Trauma, both with or without fracture, caused proliferative changes in the TMJ. The glenoid fossa, the articular disk and the articular surface of the condyle were injured. Thickening of the articular surfaces had resulted in reduced joint space. Subsequently, remodelling changes in the condyle were found.     

Matrix metalloproteinase-2 in synovial lavage fluid of patients with disorders of the temporomandibular joint.

We examined the matrix metalloproteinase-2 (MMP-2) activity in synovial lavage fluid of patients with disorders of the temporomandibular joint (TMJ) and explored the possible correlationship between MMP-2 activity and radiological changes. We studied 86 patients and 10 healthy volunteers. An arthrogram and a double contrast arthrotomogram were taken to evaluate intra-articular morphological changes. The patients were divided into three groups: no abnormality (n = 36), internal derangement (n = 39), and osteoarthritis (n = 11). Samples of synovial fluid were studied by gelatin zymography, and we sought a correlation between the band detected and radiological findings. ProMMP-2 was detected in all samples and active MMP-2 was detected in 9/36 with no abnormality, 14/39 with internal derangement and 5/11 with osteoarthritis. No active form of MMP-2 was detected in the control group. The incidence of active MMP-2 was high in the internal derangement group and highest in the osteoarthritis group, which suggests that active MMP-2 plays an important part in the development of conditions of the TMJ.     

Analysis of synovial fluid visfatin level in temporomandibular joint disorders

Background: Biochemical analysis of synovial fluid (SF) is an important means of understanding the pathogenesis of temporomandibular disorder (TMD) and confirming diagnoses made using traditional methods.

Objective: The aim of this study was to determine whether or not SF visfatin levels can serve as a biochemical marker in the diagnosis of TMD.

Method: Sixty samples of SF were obtained from 60 patients with internal derangement (ID) or osteoarthritis (OA). Visfatin in the SF was examined by enzyme-linked immunosorbent assay (ELISA).

Result: Visfatin levels showed positive correlations with TMD pain and ID stage and a negative correlation with maximum mouth opening. In addition, Visfatin levels in joints with OA changes in the condyle were significantly higher in comparison to joints with no OA changes.

Conclusion: Within the limitations of this study, it can be concluded that visfatin may play a role in the pathogenesis of TMD.     

间接性羊颞下颌关节损伤实验动物模型的建立

以不同力量撞击１０只山羊一侧下颌角部，方向平行于下颌角—颞下凹中点连线，间接造成ＴＭＪ损伤。结果发现：不同撞击力可间接引起ＴＭＪ不同程度的损伤，其损伤程度与被撞击部位的压强成正相关关系。ＴＭＪ局部出现髁突进入颅中凹，关节囊内血肿形成，关节盘挫裂、扭曲，滑膜撕裂，髁突表面软骨碎裂等病理改变。实验证明：所建立的间接性ＴＭＪ损伤动物模型操作简便，致伤力量可控，具有一致的可重复性，可引起ＴＭＪ不同程度损伤，其病变与人类相似，病变典型，因此可做为研究ＴＭＪ间接性损伤的实验动物模型。