鼠颞下颌关节创伤后感觉神经肽阳性纤维的变化

目的:观察间接创伤后鼠颞下颌关节中感觉神经肽阳性纤维分布及密度的动态变化,探讨感觉神经肽在颞下颌关节疾病中的作用。方法:将42只SD大鼠随机均分为6组,分别在创伤前、创伤后1、3、7、14和28d时处死,灌注同定后取双侧颞下颌关节,脱钙后恒冷切片,ABC法漂染,并对结果进行半定量分析。结果:创伤前鼠颞下颌关节中有广泛而丰富的降钙素基因相关肽和P物质阳性纤维的分布。创伤后两种神经肽阳性纤维的密度均显著降低,分别在创伤后3、1d达到最低值。然后逐渐增加,至28d时达到或超过正常值。结论:创伤后颞下颌关节中感觉神经肽的逆行释放显著增加。它们不仅参与痛觉传导,而且是颞下颌关节病理改变的神经源因素。     

降钙素基因相关肽阳性神经纤维在鼠颞下颌关节中的分布

目的　观察鼠颞下颌关节中降钙素基因相关肽阳性神经纤维的分布特征。方法　将鼠颞下颌关节取出 ,脱钙脱水后恒冷切片 ,以ABC法漂染后进行镜检及半定量分析。结果　除关节盘中心区外 ,颞下颌关节各部位的软组织均有丰富的降钙素基因相关肽阳性纤维 ,主要沿血管尤其是动脉周围分布 ,密度为 :前部盘周附着和关节囊 (45 4 6± 72 8)mm2 、后部 (30 2 7± 43 4)mm2 、外侧 (2 40 2± 2 3 6 )mm2 、内侧 (2 2 9 6± 2 5 0 )mm2 、盘外周区 (2 0 2 4± 35 2 )mm2 。结论　降钙素基因相关肽阳性纤维广泛分布于颞下颌关节中 ,是感觉神经的一部分 ,其密度以关节前部盘周附着及关节囊中最高     

P物质阳性神经纤维在鼠颞下颌关节中的分布与密度

目的：观察ＳＤ大白鼠颞下颌关节中Ｐ物质阳性神经纤维的分布与密度，为进一步研究Ｐ物质在颞下颌关节疾病中的作用提供形态学依据。方法：用ＳＤ雄性大鼠８只，取双侧ＴＭＪ，ＡＢＣ染色镜检，计算机图像分析。结果：Ｐ物质阳性纤维分布于关节盘周附着、关节囊、滑膜、骨膜等组织中，尤其在这些组织的血管周围更为丰富。关节盘中除致密的中心区外均有阳性纤维分布。纤维密度以前部关节囊及盘附着最高。结论：Ｐ物质阳性纤维广泛分布于鼠颞颌关节中，是三叉感觉神经纤维的一部分。     

P物质神经纤维在猫颞下颌关节内分布的研究

作者应用免疫组织化学ＰＡＰ法对Ｐ物质神经纤维在猫颞下颌关节囊及关节盘附着内的分布作了研究。结果表明：颞下颌关节囊及关节盘附人均见Ｐ物质阳性纤维分布，以中等粗细有膨体的纤维多见，其中，关节囊滑膜下层的阳性纤维分布密度最高，关节盘前后附着处的分布密度相似，但低于滑膜下层及关节囊外侧壁，滑膜内阳性纤维少见。在以上各部位均可观察到阳性经每人发布于小血管周围。本文结果为探索颞下颌关节综合征及其疼痛的神经生物     

颞下颌关节疾病

慢性不可预知性应激刺激对大鼠下颌关节超微结构的影响;无症状颞下颌关节的关节杂音声电图研究;血管化腓骨肌瓣下颌骨重建中髁突不同处理方法对颞下颌关节功能的影响评价;手法复位在单侧颞下颌关节前脱位复位中的应用;鼠颞下颌关节创伤后感觉神经肽阳性纤维的变化     

鼠颞下颌关节间接创伤后三叉神经节下颌突中肽能神经元密度的动态变化研究

目的观察鼠颞下颌关节间接创伤后,三叉神经节中降钙素基因相关肽、P物质和神经肽Y阳性反应产物密度的动态变化。方法将42只SD大鼠随机均分为6组,分别在创伤前、创伤后1、3、7、14和28d处死,取三叉神经节行ABC法漂染,并对结果进行半定量分析。结果创伤前,鼠三叉神经节中降钙素基因相关肽和P物质阳性细胞分别占神经元总数的40%和15%,但无神经肽Y胞体。创伤后,鼠三叉神经节下颌突中降钙素基因相关肽、P物质和神经肽Y阳性反应的密度均显著增加,分别在创伤后3、1和7d达到高峰,然后逐渐降低,但至28d时仍略高于正常值。结论创伤后鼠三叉神经节中神经肽合成显著增加。神经肽不仅参与痛觉传导,而且是关节炎病理改变的神经源因素。     

间接创伤对幼年大白鼠颞下颌关节血供的影响

目的　探讨间接创伤对幼年鼠颞下颌关节的影响。方法　Wistar幼年大白鼠颞下颌关节间接创伤后,应用放射性同位素测定方法对其关节区进行动态观察。结果　与正常组比较,随着创伤后对颞下颌关节区不同时间段同位素测定,创伤后颞下颌关节区放射性强度随时间增加,两周达高峰,1月时放射性强度仍比正常对照组高,在任何时间段,创伤侧都较非创伤侧颞下颌关节区放射性强度高。结论　间接创伤可以引起幼年鼠颞下颌关节局部血流变化     

双侧磨牙缺失对大鼠颞下颌关节的影响

目的　观察颞下颌关节损伤不同时期的病理生理变化 ,探讨颞下颌关节损伤与降钙素基因相关肽 (CGRP)间的相关性。方法　将拔除全部双侧上颌磨牙的 18只Wistar大鼠随机分成 3组 ,分别于拔牙后即刻 (第 1组 )、1个月 (第 2组 )及 3个月(第 3组 )处死 ,取其颞下颌关节 ,制作切片 ,苏木精 伊红染色 (HE)和CGRP免疫组化染色 ,光镜观察 ,图像分析仪计算各组切片颞下颌关节区CGRP阳性纤维的面积百分比。结果　第 1组的髁状突和关节盘无明显病理变化 ;第 2组及第 3组的髁状突和关节盘的病理变化明显 ,其 2组颞下颌关节区的CGRP阳性纤维的面积百分比明显高于第 1组 (P <0 0 1)。结论　拔除Wistar大鼠双侧上颌磨牙 1个月及 3个月后可以建立颞下颌关节损伤的实验动物模型 ;降钙素基因相关肽 (CGRP)参与了双侧后牙缺失引起的颞下颌关节损伤的病理变化过程。     

颞下颌关节疾病

鼠颞下颌关节间接创伤后三叉神经节下颌突中肽能神经元密度的动态变化研究；雌激素对颞下颌关节的影响（综述）。     

脑啡肽神经纤维在猫颞下颌关节内的分布：免疫组织化…

应用免疫组织化学ＰＡＰ法对亮氨酸－脑啡肽神经纤维在猫颞下颌关节内的分布作了研究。结果表明：ＴＭＪ囊及关节盘前后附着内均见Ｌ－ＥＮＫ阳性纤维分布，并以细枝丛状分布多见；关节囊滑膜下层的阳性纤维分布密度最高；并可见丛状结构突向滑膜层，关节囊外侧壁及关节盘前后附着内的阳性纤维分布密度相似，关节盘中部未见阳性纤维分布。     

Distribution of mucopolysaccharides and glycoproteins in the articular discs of temporomandibular joints in human fetuses

AIMS: To evaluate the distribution of mucopolysaccharides and glycoproteins in the articular discs of temporomandibular joints (TMJs) in human fetuses at different stages of development in order to test the hypothesis that the development and histological maturation of the articular disc has already begun by the 12th week of gestation. METHODS: Eighteen human fetuses at gestational ages 12, 14, and 16 weeks were used (6 fetuses of each age). Sections (6 microm wide) of the articular discs were stained with trichromic stain for collagen fibers, Mayer's mucicarmine for mucopolysaccharides, and Schiff's periodic acid reaction for glycoproteins. The densities of the stained zones were measured by means of Image J software. The nonparametric Kruskal-Wallis test was used to evaluate the differences among stained zones in the 3 fetus groups. RESULTS: TMJ tissues of four of the six 12-week-old fetuses were stained positive for collagen fibers, mucopolysaccharides, and glycoproteins. In these fetuses the stain was localized to the articular posterior area and was denser in that area than in the middle and anterior areas. The stained areas in the 14-week-old fetuses were distributed throughout the articular discs, with isolated clear unstained areas. The stained areas of all the articular discs of the 16-week-old fetuses were more compact than those of the 12-and 14-week-old fetuses. In all the fetuses examined, the collagen fibers along the articular disc had a wavy appearance. The fossa of the temporal bone was observed in all the fetuses as a straight structure that was similar in the 3 fetus groups. The densities (mean +/- SD) of the stained zones were 38.36% +/- 3.39%, 59.5% +/- 1.56%, and 94.04% +/- 2.04% for 12, 14, and 16 weeks of gestation, respectively; these densities were significantly different (chi2 = 15.16; df = 2, P < .001). CONCLUSION: This study indicates that mucopolysaccharides and glycoproteins as well as collagen fibers are present at 12, 14, and 16 weeks of gestation. This suggests that the histological maturation of the articular disc has already begun at the 12th week and is complete by the 16th week of gestation.     

人前磨牙牙髓牙本质复合体的VIP阳性神经纤维

目的研究血管活性肠肽(vasoactive intestinal peptide,VIP)在牙髓牙本质复合体中的表达,探讨其分布与功能的关系。方法收集新鲜健康的人前磨牙40颗,固定、脱钙、石蜡包埋切片,然后进行VIP免疫组化与图象定量分析。结果VIP阳性神经纤维在根部呈束状,很少分支,从颈部至冠髓扇形分开,大量分支,部分围绕于血管,部分止于牙髓基质,部分经成牙本质细胞层进入前期牙本质。在冠髓的积分光密度为12.7400±1.8070,体密度为0.0192±0.0127,线密度为0.0046±0.0028;在前期牙本质的积分光密度为13.0700±1.9270,线段长度为（19.6000±8.5970）μm。结论VIP阳性神经纤维存在于人牙髓牙本质复合体中,部分围绕血管,部分止于牙髓基质和前期牙本质,这种分布提示该神经纤维除与血管运动有关外,可能还与感觉有关。     

Transitional joint effusion in the mandibular prognathic surgery patient: intraoral vertical ramus osteotomy versus sagittal split ramus osteotomy.

PURPOSE: The purpose of this study was to examine the cause of joint effusion (JE) appearing postoperatively in the temporomandibular joint (TMJ) of patients with mandibular prognathism on T2-weighted magnetic resonance (MR) images. PATIENTS AND METHODS: MR imaging was performed before and after surgery in 30 TMJs of 15 subjects with mandibular prognathism who underwent intraoral vertical ramus osteotomy (IVRO) and in 20 TMJs of 10 subjects with mandibular prognathism who underwent sagittal split ramus osteotomy (SSRO). The preoperative MR imaging was performed 1 month before surgery, and postoperative MR imaging was performed during maxillomandibular fixation. RESULTS: Preoperatively, none of SSRO and IVRO groups had JE. Postoperatively, 12 TMJs (40%) of the IVRO group and only 1 TMJ (5%) of the SSRO group had JE. As for the TMJs in the IVRO group, on MR imaging, the degree of downward movement of the condyle after surgery was larger in TMJs with JE (3.8 +/- 2.3 mm) than in TMJs without JE (1.8 +/- 1.6 mm). JE diminished within about 4 months after removal of the maxillomandibular fixation. CONCLUSION: JE appearing postoperatively in the TMJ of patients with mandibular prognathism might be relation to the degree of downward movement of the condyle.     

鼠创伤性颞下颌关节炎模型的建立

目的 建立创伤性颞下颌关节炎动物模型,研究间接创伤对颞下颌关节的作用。方法 使重1kg的铁块自45cm高处自由落下,由下颌角向关节凹方向撞击鼠颞下颌关节,运用组织病理和图象分析法观察创伤后1、3、7、14、21和28天各组鼠颞下颌关节的病理改变。结果 病理改变:术后1～3天,以组织的损伤和急性炎症为主;术后3～14天,以组织的进行性破坏为主;术后14～28天,以组织的增生和修复为主。结论 间接创伤引起创伤性颞下颌关节炎,创伤后组织的过度增生可能是关节紊乱和强直的主要原因。     

The use of arthrocentesis for the treatment of osteoarthritic temporomandibular joints.

PURPOSE: The purpose of this retrospective study was to determine the efficacy of arthrocentesis in restoring the functional capacity of osteoarthritic temporomandibular joints (TMJ). PATIENTS AND METHODS: This study involved 36 patients (29 females, 7 males; age range, 16 to 54 years, mean, 37.36 +/- 14.60 years) presenting with 38 dysfunctional joints that had not responded to conservative treatment. The postarthrocentesis status (follow-up period 6 to 62 months, mean 20.7 +/- 20.5 months) of the TMJs was determined by patient self-evaluation using visual analog scales and clinical examination. RESULTS: Of the 38 TMJs treated with arthrocentesis, 26 joints reacted favorably to the treatment; pain and dysfunction scores were reduced from 9.86 +/- 0.73 to 3.39 +/- 0.76 and from 11.34 +/- 0.66 to 3.4 +/- 0.69, respectively (P <.001). Self-assessed general improvement/deterioration was +4.90 +/- 2.10 (on a scale of -7 to +7). Maximal mouth opening increased from 24.40 +/- 2.70 mm to 43.20 +/- 3.10 mm (P <.001). Lateral and protrusive jaw movements also increased in magnitude. In 14 patients in whom no improvement was noted, arthrocentesis acted as a diagnostic tool before surgical treatment. CONCLUSIONS: Arthrocentesis is a safe and rapid procedure that in many instances results in the osteoarthritic TMJs returning to a healthy functional state. Failure of arthrocentesis suggests that the painful limitation is most probably caused by changes such as fibrous adhesions or osteophytes that require surgical intervention for their removal.     

Autogenous dermal grafts for repair of temporomandibular joint disc perforations

Perforations of the temporomandibular joints (TMJs) disc were made in the rabbits and repaired with autogenous dermal grafts. The healing process was investigated histologically. Twenty-one rabbits (forty-two TMJs) were divided into 3 experimental groups. Group 1. Six TMJs in which the superior aspects of the discs were exposed by the incision of the articular eminence. Group 2. Fifteen TMJs in which the discs were perforated. Group 3. Twenty-one TMJs in which the dermal grafts were sutured on the disc perforations. The results obtained were as follows: In group 2, all perforations were not repaired, except in one case. In group 3, 14/19 grafted disc perforations were repaired. One week after surgery, young, loose, collagenous tissue from the synovial membrane lined the margins of the perforations. Two weeks after surgery, vascularity from the synovial membrane and young collagen fibers were seen in the area of the repaired perforations. Four weeks after surgery, long and thick collagen fibers bridged the perforations.     

Dynamic intra-articular space variation in clicking TMJs

During mandibular movement, the geometric relationships of the articular surfaces in the temporomandibular joint (TMJ) change, so that the disc undergoes different stress concentrations with respect to time and position. In this study, we compared the intra-articular space variations of 13 clicking and 15 asymptomatic TMJs for jaw opening/closing. Magnetic resonance imaging and jaw tracking were combined to display the motion of the whole condyle within the fossa. In clicking TMJs, the mediolateral spread s of the stress-field trajectories was 2.4 +/- 1.0 mm (s(max) = 4.9 +/- 2.1 mm) with an aspect ratio a/h of 2.5 +/- 1.6, both significantly greater than in controls (p < 0.05). The stress-field trajectories of the controls coincided during opening/closing (s = 0.9 +/- 0.2 mm, s(max) = 1.8 +/- 0.8 mm, a/h = 1.6 +/- 0.3). Clicking TMJs showed much less coincident stress-field paths and much "flatter" stress-fields than controls during jaw opening/closing.