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单侧椎间盘切除术和髁突切除术对兔对侧完整颅下颌关节的影响。

The effects of unilateral discectomy and condylectomy on the contralateral intact rabbit craniomandibular joint.

作者信息

Dimitroulis George, Slavin John

机构信息

Department of Special Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia.

出版信息

J Oral Maxillofac Surg. 2006 Aug;64(8):1261-6. doi: 10.1016/j.joms.2006.04.023.

Abstract

PURPOSE

The purpose of this study is to determine the effects of unilateral discectomy and condylectomy on the contralateral intact rabbit craniomandibular joint at the histological level.

MATERIALS AND METHODS

Fifteen New Zealand white rabbits were used and divided into 3 groups. Three rabbits were used as controls (group A) whereby a sham operation was undertaken without breaching the joint space of the left craniomandibular joint (CMJ). In 6 rabbits (group B), the articular disc of the left CMJ was excised. The remaining 6 rabbits (group C) underwent surgical resection of the left condylar head at the level of the condylar neck. The resultant surgical defects were left to heal without any grafting and the incisions were closed with resorbable sutures. The rabbits were sacrificed at 4, 12, and 20 weeks after surgery and both the left and right CMJs were histologically prepared and examined under light microscopy.

RESULTS

In the 4-week group, unilateral discectomy and condylectomy resulted in remodeling of the unoperated right CMJ with histological evidence of flattening of the condylar head which was more pronounced in the condylectomy group. In the 12-week group, the remodeling process in the unoperated right CMJ was less pronounced with most of the activity concentrated in the medial pole, especially in the condylectomy group. The 20-week group showed no obvious signs of remodeling in the unoperated right CMJs in both the discectomy and condylectomy groups. Evidence of condylar regeneration was seen in all groups in the left CMJ which had undergone condylectomy. No evidence of disc regeneration in the operated left CMJ was seen in any of the discectomy groups.

CONCLUSIONS

Unilateral discectomy and condylectomy have an early adverse effect on the structural integrity of the contralateral unoperated CMJ which appears to be short lived. The early remodeling effects on the unoperated right CMJ appear to be reversible as the operated left CMJ heals.

摘要

目的

本研究旨在从组织学层面确定单侧椎间盘切除术和髁突切除术对兔对侧完整颅下颌关节的影响。

材料与方法

选用15只新西兰白兔,分为3组。3只兔子作为对照组(A组),进行假手术,不打开左颅下颌关节(CMJ)的关节间隙。6只兔子(B组)切除左CMJ的关节盘。其余6只兔子(C组)在髁突颈部水平进行左髁突头部的手术切除。手术造成的缺损任其自行愈合,不进行任何移植,切口用可吸收缝线缝合。术后4周、12周和20周处死兔子,对左右CMJ进行组织学处理,并在光学显微镜下检查。

结果

在4周组,单侧椎间盘切除术和髁突切除术导致未手术的右侧CMJ发生重塑,组织学证据显示髁突头部变平,在髁突切除术组更为明显。在12周组,未手术的右侧CMJ的重塑过程不太明显,大多数活动集中在内侧极,尤其是在髁突切除术组。20周组显示,椎间盘切除术和髁突切除术组未手术的右侧CMJ均无明显重塑迹象。在所有进行髁突切除术的左侧CMJ组中均可见髁突再生的证据。在任何椎间盘切除术组中,手术的左侧CMJ均未见椎间盘再生的证据。

结论

单侧椎间盘切除术和髁突切除术对未手术的对侧CMJ的结构完整性有早期不良影响,但这种影响似乎是短暂的。随着手术的左侧CMJ愈合,对未手术的右侧CMJ的早期重塑影响似乎是可逆的。

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