Thurmüller Petra, Troulis Maria J, Rosenberg Andrew, Chuang Sung-Kiang, Kaban Leonard B
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, and Harvard Medical School, Boston, MA 02114, USA.
J Oral Maxillofac Surg. 2006 Feb;64(2):249-58. doi: 10.1016/j.joms.2005.10.010.
Unilateral mandibular distraction osteogenesis (DO) has been shown to cause gross changes in the mandibular condyle and articular disc. The purpose of this study was to correlate histologic findings with these gross changes in a minipig distraction model.
Semiburied distractors were placed via submandibular incisions in 15 minipigs. Two unoperated animals served as controls. The protocol consisted of 0-day latency and rates of 1, 2, or 4 mm/day for a 12-mm gap. After the minipigs were killed (at 0, 24, or 90 days), ipsilateral and contralateral condyles and discs were harvested, decalcified, prepared for standard paraffin embedding, and evaluated to determine changes in 1) morphology and thickness of the articular cartilage and subchondral bone and 2) morphology of the disc.
In control animals, there were no degenerative changes in the articular cartilage and underlying condylar bone; there were no significant differences in the mean articular cartilage thickness. The temporomandibular joint discs were normal. In experimental animals, distracted condyles showed increasing degenerative changes and mean articular cartilage thickness as the DO rate increased. The discs were thinner. These changes were present, but to a lesser degree, in the contralateral condyles. After 90 days, degenerative changes in the condyles and discs were reduced, after remodeling, except in the 4 mm/day DO group.
Histologic changes in the condyles and temporomandibular joint discs in response to mandibular DO correlated with previously reported gross changes. These changes were greater at higher distraction rates and remodeling back to normal occurred in mandibular condyles distracted at 1 mm/day.
单侧下颌骨牵张成骨术(DO)已被证明会导致下颌髁突和关节盘发生明显变化。本研究的目的是在小型猪牵张模型中,将组织学结果与这些明显变化相关联。
通过下颌下切口在15只小型猪中放置半埋入式牵张器。两只未手术的动物作为对照。方案包括0天延迟期,以每天1、2或4毫米的速率形成12毫米的间隙。在小型猪处死(0、24或90天)后,采集同侧和对侧的髁突和关节盘,脱钙,制备用于标准石蜡包埋,并进行评估以确定以下方面的变化:1)关节软骨和软骨下骨的形态和厚度,以及2)关节盘的形态。
在对照动物中,关节软骨和下方的髁突骨没有退行性变化;平均关节软骨厚度没有显著差异。颞下颌关节盘正常。在实验动物中,随着牵张速率增加,牵张侧髁突的退行性变化和平均关节软骨厚度增加。关节盘变薄。对侧髁突也出现了这些变化,但程度较轻。90天后,除了每天4毫米牵张速率组外,髁突和关节盘的退行性变化在重塑后有所减轻。
下颌骨牵张导致的髁突和颞下颌关节盘的组织学变化与先前报道的明显变化相关。这些变化在较高牵张速率时更大,并且以每天1毫米牵张的下颌髁突会重塑恢复正常。