颞下颌关节的观测

本文在２０９具成年标本上对颞下颌关节的下颌窝、下颌头、关节盘及关节囊进行了观测;对颞下颌关节的运动及弹响机制进行了讨论。     

中国全新世女性下颌骨测量性状的时代变化

目的 通过对全新世215例成年女性下颌骨的测量项目的对比分析,探讨女性下颌骨测量性状的微观演化问题。方法 对23个下颌骨测量性状进行测量,并运用SPSS 18.0统计学软件对各时代测量性状数据进行均值计算和不同时代间差异的显著性检验。结果 从新石器时代经过青铜铁器时代到现代,下颌骨趋向于缩小。在不同的时代阶段,下颌骨各个性状的表现特点和变化幅度亦不相同。下颌体厚度的变化主要发生在新石器 青铜铁器时代,下颌骨大体尺寸的缩小、下颌体高的减小主要发生在青铜铁器 现代。下颌骨的时代变化首先体现在下颌体厚度上,然后才是下颌骨的大体尺寸和下颌体高。结论 全新世女性下颌骨仍在进化,女性下颌骨的演化特点和趋势与男性下颌骨相似。     

包含颞下颌关节的下颌骨有限元建模

为获得颞下颌关节下颌骨的应力分布提供更为有效的有限元模型。用Mimics10．0导入正常人的颌面CT建立其下颌各部位的有限元模型,通过CAE软件ABAQUS 6．10进行有限元分析。获得了完整的下颌骨、颞下颌关节有限元模型,及后牙咬合状态下模型各部位应力分布等数据。通过分析数据发现,关节盘高应力区主要集中在关节盘中带和后带,而关节盘各部分应力表现为关节盘颊侧应力高于舌侧,顶部应力高于底部,中带平均应力最大,后带次之,前带最小。     

颞下颌关节与颅面指标的计算机相关及回归分析

本文用计算机分析统计了118例(236侧)颞下颌关节的12项骨性指标及10项颅面指标的正常值及相关关系。结果表明颞下颌关节各项指标之间、颞下颌关节与颅面各主要指标之间,均存在良好的相关关系。说明颞下颌关节,特别是关节窝和髁突的形态大小具有明显的规律性。由于颅面诸指标与颞下颌关节主要指标之间高度相关,因而本文用逐步回归方法,建立了由颅面特征指标推算髁突形态的回归方程。本文的结果可为该关节的形态研究及人工关节的设计和应用提供有益的依据。     

钟基因Bmal1在颞下颌关节骨关节炎中的作用机制

背景：颞下颌关节骨关节炎是口腔科常见疾病,其发病机制复杂,近来发现时钟基因Bmal1表达减少可以导致小鼠颞下颌关节发生骨关节炎样病理改变,但Bmal1在颞下颌关节骨关节炎中的作用机制尚不清楚。目的：总结钟基因Bmal1在颞下颌关节骨关节炎发生发展中可能的作用机制,为颞下颌关节骨关节炎的发病机制提供新思路。方法：检索中国知网、PubMed、Web of Science数据库建库至2022年的文献,中文检索词为“颞下颌关节骨关节炎,骨关节炎,颞下颌关节紊乱病,髁突软骨,Bmal1,昼夜节律,生物钟,睡眠”,英文检索词为“TMJOA,osteoarthritis,TMD,condylar cartilage,Bmal1,circadian rhythms,circadian clock,sleep”,根据纳入和排除标准,共纳入50篇文章进行分析总结。结果与结论：(1)睡眠剥夺引起的昼夜节律紊乱可以导致小鼠颞下颌关节发生骨关节炎样病理改变,暗示昼夜节律紊乱是诱发颞下颌关节骨关节炎发生的新的危险因素;(2)Bmal1作为昼夜节律的核心时钟因子,在维持颞下颌关节软骨内稳态方面发挥重要作用;(3)当...     

3 种不同髁突头部形态全颞下颌关节假体的生物力学研究

目的 对个性化聚醚醚酮(polyetheretherketone, PEEK)全颞下颌关节假体进行三维建模,通过有限元分析 3 种不同髁突头部形态(原型、80% 原型及圆柱形)假体的应力分布特征,评估 3 种不同髁突头部形态对 PEEK 全颞 下颌关节假体稳定性、关节运动以及关节窝的影响。 方法 建立颅颌面及 PEEK 全颞下颌关节假体有限元分析模 型Ⅰ、Ⅱ、Ⅲ,分析在牙尖交错位、切 颌位、左侧磨牙颌位及右侧磨牙颌位 4 种不同咬合条件下,关节窝假体、髁突 假体、钛钉最大应力,下颌骨应力、应变分布,以及 3 种模型的最大位移。 结果 3 种模型 PEEK 全关节假体及螺钉 的最大应力分别为 35. 22、16. 73 MPa,均低于其材料的屈服强度;模型Ⅰ、Ⅱ、Ⅲ下颌骨最大应力分别为 41. 47、42. 84、 56. 92 MPa,应变分别为 3. 896×10-3 、2. 175×10-3 、4. 641×10-3 。 3 种模型的最大位移为 209. 0 μm,位于模型Ⅲ的左侧下 颌角处。 结论 3 种不同髁突头部形态的个性化 PEEK 全颞下颌关节假体均显示出较为均匀的应力应变分布,但髁 突头部形态为 80% 原型假体的力学效果更好。 研究结果为 PEEK 全颞下颌关节的设计提供一定理论依据。     

中国全新世人群头骨尺寸性别差异的时代比较

目的:分析全新世人群头骨尺寸性别差异率的时代间变化,并对比探讨男女头骨尺寸的时代变化率。方法:以中国考古遗址520例头骨为研究材料,用SPSS18.0软件进行同一时代男女测量性状的比较、不同时代间测量性状的比较,同时计算相应的性别差异率和时代变化率。结果:性别差异率分析显示,在男女头骨尺寸差异中,头骨高度的差异相对较大,现代人群面颅尺寸的性别差异率大于脑颅。"新石器-现代"的头骨时代变化率显示,头骨尺寸随时代而缩小,眶高增大,眶宽变小,这些变化在男女中较一致,但女性头骨缩小程度大于男性。结论:相比新石器与青铜铁器时代,现代人群中头骨尺寸性别差异率最大,可能主要源于新石器时代以来,头骨趋向于缩小的微观演化中,女性随时代减小的程度更加明显。     

全新世女性颏孔、下颌孔的位置特征及时代间比较*

目的：探讨全新世女性群体颏孔位置、颏孔开口方向、下颌孔位置等在不同时代的表现特点,并探讨可能 存在的时代间变异。方法：对中国全新世201 例女性下颌骨的颏孔、下颌孔的体质特征进行分类和记录,然后用 SPSS 19.0 软件进行出现率统计及时代间差异显著性检验。结果：所比较的性状在不同时代间的表现特点具有一 定相似性：颏孔位置主要在下颌第2 前臼齿（P4）下面,颏孔开口方向主要为“后上”,下颌孔位置（ 水平方向） 主要为“下颌支中点之后”,下颌孔位置（ 垂直方向）主要为“齿槽面之上”。同时,不同时代间也存在一些差异, 近代人群颏孔位置相对靠后、下颌孔位置相对较高。结论：从青铜铁器时代到近代,女性的颏孔位置有相对后移 趋势;这些变化可能与该时段内下颌骨尺寸变小有一定的相关性。下颌孔位置时代间差异较小。     

广东地区人群颞下颌关节解剖参数的三维分析

目的 对广东地区不同人群的下颌骨及髁突解剖参数进行三维分析。 方法 选取就诊于南方医科大学口腔医院的患者265名,利用CBCT分别测量男性和女性的髁突长度、髁突高度、下颌升支高度、下颌体高度以及下颌神经进入下颌升支的位置。 结果 所有患者髁突的平均长度（内极-外极）二维测量为19.2 mm、三维测量为20.3 mm,男性比女性长3.6 mm,两者之间无统计学差异。下颌骨高度、髁突高度和下颌升支高度分别为59.6 mm,22.8 mm和38.3 mm,其中下颌骨高度男性比女性长6.4 mm,两性之间有统计学差异。下颌升支的宽度、下颌小舌到升支前缘的距离和下颌小舌到升支后缘的距离分别为：29.4 mm,14.8 mm及14.6 mm,男女之间均无统计学差异。 结论 CBCT测量颞下颌关节有着更显著的准确性,本实验结果丰富了中国人群下颌骨解剖数据,有助于开发适合广东地区的人工颞下颌关节。 【关键词】 下颌骨; 髁突; CBCT; 人工颞下颌关节     

青少年颞下颌关节骨关节病患者髁突在关节窝内间隙变化与骨质破坏位置的相关性

背景：国内外对于青少年颞下颌关节骨关节病患者的相关研究甚少,以往采用传统X射线平片检查方法,近年来通过口腔锥形束CT手段获取图像资料分析优势显著,不仅可以了解髁突影像学变化特征,而且可为青少年颞下颌关节骨关节病患者在临床诊断及治疗中提供参考。目的：对青少年颞下颌关节骨关节病患者进行锥形束CT测量分析,评价在影像学成像方面的异常形态及影响因素。方法：选择80例颞下颌关节骨关节病的青少年（试验组）和80例无症状青少年（对照组）,均于牙尖交错位进行锥形束CT扫描,使用Invivo 5.2软件对两组患者进行颞下颌关节三维重建影像测量研究：（1）矢状位测量：包括颞下颌关节上间隙、前间隙、后间隙;（2）轴位测量：包括颞下颌关节髁突前后径、内外径;（3）三维立体成像：下颌升支的高度;（4）试验组颞下颌关节骨关节病各病理改变类型的百分比。结果与结论（1）据统计试验组中男27例,女53例,男、女比例约为1∶2;（2）组内比较：试验组双侧颞下颌关节关节上间隙、后间隙差异有显著性意义（P <0.05）;对照组双侧颞下颌关节的关节测量值相比差异均无显著性意义（P> 0.05）;（3）组间比较：试验...     

Genes that regulate morphogenesis and growth of the temporomandibular joint: A review

Compared with the joints of the limbs, our understanding of the genes that regulate development and growth in the temporomandibular joint (TMJ) is fairly limited. Because the morphogenesis of the secondary cartilage and other intra‐articular structures in the TMJ occurs later and in a different manner than in the limbs, the genetic control of TMJ development might reasonably be assumed to differ from that in the limbs. However, studies of the specific genes regulating TMJ morphogenesis and growth have only begun to appear in the literature within the last decade. This review attempts to survey and interpret the existing knowledge on this topic and to suggest fruitful avenues of investigation for the future. Studies to date using knockout and over‐expression of candidate genes suggest that a developmental hierarchy of joint structures exists, with condyle development primary. A hierarchy of gene expression also exists: Runx2 and Sox9 expression is critical for condylar cartilage formation. Several of the other genes discussed in this report may regulate TMJ morphogenesis by affecting Sox9 and Runx2 expression and control the ihh‐PTHrP axis by means of these genes. Developmental Dynamics 243:864–874, 2014. © 2014 Wiley Periodicals, Inc.     

成人下颌孔及周边骨性结构的解剖特点

目的:研究成人下颌孔及周边骨性结构的解剖特点,为临床手术操作提供解剖参考和依据.方法:由口腔专业教师确定各解剖结构的位置并标记,用游标卡尺、量角器、直尺和圆规对下颌骨进行测量,记录数据并进行统计学分析.结果:有76.00％的下颌孔位于下颌支内面中点之后,有87.00％的下颌孔位于下颌支内面中点之上;下颌孔的内外径为3....     

Size variation of Chinese craniums and mandibles in Holocene

目的:对比分析中国新石器时代以来头骨、下颌骨尺寸的微观演化.方法:用直脚规、弯脚规对中国新石器时代、青铜铁器时代和近代共502例头骨/下颌骨标本进行测量,然后用SPSS 13.0软件进行数据分析.结果:头骨、下颌骨大体尺寸的变化都主要发生在青铜铁器一近代.从新石器时代到近代,下颌骨表现为整齐的趋向于缩小,而头骨部分项目不变、部分增大、部分缩小,变化规律不如下颌骨那样整齐和明显,且头骨变化幅度和比例小于下颌骨.结论:近7000年来中国全新世人群的头骨、下颌骨都在进化,男女性变化基本一致.各种原因导致的头颅的变化在下颌骨上的表现更明显,头骨、下颌骨在全新世的体质特征演化不平衡,全新世头面部可能趋向于“瓜子脸”.     

An anatomical study of the muscles that attach to the articular disc of the temporomandibular joint

The masticatory muscles are generally described as the muscles that originate from the cranium and insert on the mandible. Some of the masticatory muscles also insert into the articular disc of the temporomandibular joint. Although there are numerous reports of studies on the attachment of the fibers to the disc, most reports discuss only one muscle. We have shown that the masticatory muscles are not simply a group of clearly independent muscles, but that these muscles contain various transitional muscle bundles among the major muscles. From this point of view, we carried out minute dissection of the collective muscles and muscle bundles surrounding the temporomandibular joint. We dissected 40 head halves of 20 Japanese cadavers (10 males, 10 females: average 79.6 yr). After complete removal of the bony elements, the structures surrounding the temporomandibular joint were investigated en‐block. In all specimens, the superior surface of the upper head of lateral pterygoid and the midmedial muscle bundle were attached to the disc. In some specimens, the discotemporal bundle, zygomaticomandibularis, and masseter were attached to the anterior surface of the disc. The total vector of these muscles pulls the disc anteriorly. In contrast, the vector of the muscles to the condylar processes of the mandible pulls the mandible medially. From these observations, it seems that the fibers, which attach to the disc act to steady the disc against the masticatory movement. Clin. Anat. 22:932–940, 2009. © 2009 Wiley‐Liss, Inc.     

Factors affecting the variation in the adult temporomandibular joint of archaeological human populations

To elucidate factors that may affect the variation in the bony components of temporomandibular joint (TMJ), a preliminary study was conducted on the temporal articular surface of the TMJ of 30 skulls from Iron Age and medieval populations from Lithuania and a mixed Neolithic and Bronze Age population from the Central Elbe-Saale region (CESR). Using three-dimensional (3D) photos of the skulls, length and width measurements of the TMJ were obtained and compared with external skull measurements. Distinct, random variation between the TMJ values from opposite sides of the cranium were identified as fluctuating asymmetry. ANOVA results suggest significant differences in the length of the TMJ between the population of the CESR and the two Lithuanian populations, but not between the two Lithuanian populations. Environmental factors, including geography, may be responsible for the variation in the TMJ form.     

新石器时代至近代成年男性下颌骨颏孔、下颌孔大小的变化

目的 探讨中国全新世人群颏孔、下颌孔尺寸的变异.方法 用游标卡尺对中国北方地区新石器时代(54例)、青铜铁器时代(186例)和近代(92例)共332例成年男性颏孔、下颌孔大小进行测量,然后用SPSS13.0软件进行数据分析.结果 近代颏孔、下颌孔较大,新时器时代、青铜器时代的颏孔下颌孔较小.结论 从新石器时代经过青铜铁器时代到近代,颏孔、下颌孔有增大的趋势.这种变化主要发生于青铜铁器时代至近代,与下颌骨变小的时段一致.     

Development of the mandibular condylar cartilage in human specimens of 10–15 weeks' gestation

This study analyses some morphological and histological aspects that could have a role in the development of the condylar cartilage (CC). The specimens used were serial sections from 49 human fetuses aged 10–15 weeks. In addition, 3D reconstructions of the mandibular ramus and the CC were made from four specimens. During weeks 10–11 of development, the vascular canals (VC) appear in the CC and the intramembranous ossification process begins. At the same time, in the medial region of the CC, chondroclasts appear adjacent to the vascular invasion and to the cartilage destruction. During weeks 12–13 of development, the deepest portion of the posterolateral vascular canal is completely surrounded by the hypertrophic chondrocytes. The latter emerge with an irregular layout. During week 15 of development, the endochondral ossification of the CC begins. Our results suggest that the situation of the chondroclasts, the posterolateral vascular canal and the irregular arrangement of the hypertrophic chondrocytes may play a notable role in the development of the CC.     

An in situ hybridization study of the Syndecan family in the developing condylar cartilage of fetal mouse mandible

Mandibular condylar cartilage is a representative secondary cartilage, differing from primary cartilage in various ways. Syndecan is a cell-surface heparan sulfate proteoglycan and speculated to be involved in chondrogenesis and osteogenesis. This study aimed to investigate the expression patterns of the syndecan family in the developing mouse mandibular condylar cartilage. At embryonic day (E)13.0 and E14.0, syndecan-1 and -2 mRNAs were expressed in the mesenchymal cell condensation of the condylar anlage. When condylar cartilage was formed at E15.0, syndecan-1 mRNA was expressed in the embryonic zone, wherein the mesenchymal cell condensation is located. Syndecan-2 mRNA was mainly expressed in the perichondrium. At E16.0, syndecan-1 was expressed from fibrous to flattened cell zones and syndecans-2 was expressed in the lower hypertrophic cell zone. Syndecan-3 mRNA was expressed in the condylar anlage at E13.0 and E13.5 but was not expressed in the condylar cartilage at E15.0. It was later expressed in the lower hypertrophic cell zone at E16.0. Syndecan-4 mRNA was expressed in the condylar anlage at E14.0 and the condylar cartilage at E15.0 and E16.0. These findings indicated that syndecans-1 and -2 could be involved in the formation from mesenchymal cell condensation to condylar cartilage. The different expression patterns of the syndecan family in the condylar and limb bud cartilage suggest the functional heterogeneity of chondrocytes in the primary and secondary cartilage.