咬合创伤对颞颌关节软组织P物质样免疫反应的影响

为了探讨咬合创伤在颅颌紊乱症发生及发展中的生化机制，作者首次运用免疫组化技术观察小型猪正常时颞颌关节（ＴＭＪ）软组织Ｐ物质（ＳＰ）样免疫阳性反应的分布及其在咬合创伤时的反应变化。结果显示，除关节盘中带中部外，ＴＭＪ软组织各部均有ＳＰ样阳性反应分布，其中以关节盘周围为多，滑膜表层较少。咬合创伤时ＴＭＪ软组织中ＳＰ样免疫阳性反应增强，盘周附着组织中最为显著，滑膜组织也较明显。去除咬合创伤后ＳＰ样阳性反应明显减弱。提示盘周附着和滑膜组织对咬合创伤较敏感，由此引起的ＴＭＪ炎症和疼痛有ＳＰ的参与机制。

EFFECTS OF TRAUMATIC OCCLUSION ON SUBSTANCE P-LIKE IMMUNOLOGIC REACTION OF TMJ SOFT TISSUES

It is much complicated in the pathogenetic mechanisms of the craniomandibular disorders (CMD). We have reported that the effects of traumatic occlusion on the histopathology of the temporomandibular joint (TMJ) and masticatory muscles. Those results indicated that traumatic occlusion caused injury to TMJ and masticatory muscles indeed. The authors believe that traumatic occlusion is one of the pathogenic factors in CMD. To study the neurobiologic machanisms of the development of CMD caused by the traumatic occlusion, the distribution of Substance P-like Immunol Reaction (SPIR) of the TMJ soft tissues in the miniature pigs and the changes of SPIR during the traumatic occlusion were, for the first time, observed with immunohistochemical staining. SP has been attributed a role as a transmitter or modulator in many parts of the central and peripheral nervous system, and play a important role in the transmission of nociceptive information. It has also been suggested that SP is released peripherally in the axon-reflex to local injurious stimuli and produces neurogenic inflammatory reactions. The results of this study showed that the positive SPIR are found in all soft tissues of the TMJ except the middle part of the disc, and distributed in the peripheral part of the disc mostly, whereas that distributed a little in the surface layer of the synovial membrane. The positive SPIR increased in all soft tissues of the TMJ during the traumatic occlusion with different extents. The positive SPIR are the strongest in the attachment of the disc, also stronger in the synovial membrane, and reduced obviously after the traumatic occlusion were removed. The facts demonstrate that the attachment of the disc and the synovial menbrane are sensitive to the traumatic occlusion, and SP machanisms participate in the pain and inflammation of TMJ caused by the traumatic occlusion.