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双侧下颌骨骨牵张对髁突软骨的影响:一项在兔身上的实验研究。

Effect of bilateral mandibular osteodistration on the condylar cartilage: an experimental study on rabbits.

作者信息

Elgazzar Reda F, El-Bialy Tarek H, Megahed Eman

机构信息

Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Manitoba.

出版信息

Open Dent J. 2008;2:103-8. doi: 10.2174/1874210600802010103. Epub 2008 Oct 20.

Abstract

UNLABELLED

Although various aspects of bone formation during distraction osteogenesis have been studied extensively, there are only limited experimental data concerning the influence of hyper-physiologic mandibular distraction rate on structural alterations in the temporomandibular joint (TMJ) condylar cartilage. The purpose of this study was to evaluate the effect of bilateral distraction osteogenesis of the mandibular body, at a hyper-physiologic rate and length, on the integrity of the condylar cartilage in rabbits.

MATERIALS AND METHODS

Eighteen healthy adult male rabbits weighing 2 to 3 kg were assigned to 1 of 2 groups: the control group (n = 2 rabbits, 4 joints) or the study group (n = 16 rabbits, 32 joints) four rabbits (8 joints) in each subgroup according to the post-distraction period (1,2,3 or 4 weeks). In the control group, rabbits received sham surgery (Osteotomy without distraction) and then left to live for 4 weeks under the same condition of the study group then euthanized using intravenous overdose of pentobarbital sodium. In the study group, an extra oral custom-made distracter was employed to achieve bilateral mandibular hyper physiologic distraction (1.5 mm twice daily for 5 days) distraction. All animals were evaluated clinically and histomorphometrically and results analyzed by MINITABE 13.1 statistical package using ANOVA test.

RESULTS

Animals underwent distraction showed obvious changes in condylar surface contour related to length of the follow up period, compared to the control; these changes seemed to be partly reversible. The most pronounced observation was the irregularities and resorption in the anterior part of the condylar cartilage and the subcondylar bone. Moreover, at the first two weeks, the area of resorption was invaded by large number of osteoclasts and chronic inflammatory cells which declined later in the 3rd and 4th weeks and replaced with osteoblastic activities.

CONCLUSION

These experimental data showed that distraction rate of 3 mm per day may lead to degenerative or even early arthritic changes in the TMJ condylar cartilage in the 1st and 2nd post-distraction weeks. However, all condyles showed adaptive and remodeling sings in the following 3rd and 4th weeks.

摘要

未标注

尽管在牵张成骨过程中骨形成的各个方面已得到广泛研究,但关于超生理下颌牵张速率对颞下颌关节(TMJ)髁突软骨结构改变影响的实验数据却十分有限。本研究的目的是评估以超生理速率和长度对兔下颌体进行双侧牵张成骨对髁突软骨完整性的影响。

材料与方法

将18只体重2至3千克的健康成年雄性兔分为2组中的1组:对照组(n = 2只兔,4个关节)或研究组(n = 16只兔,32个关节),根据牵张后时间(1、2、3或4周),每个亚组有4只兔(8个关节)。对照组兔接受假手术(截骨但不牵张),然后在与研究组相同的条件下饲养4周,随后通过静脉注射过量戊巴比妥钠实施安乐死。研究组采用口外定制牵张器进行双侧下颌超生理牵张(每天2次,每次1.5毫米,持续5天)。对所有动物进行临床和组织形态计量学评估,并使用MINITABE 13.1统计软件包通过方差分析检验对结果进行分析。

结果

与对照组相比,接受牵张的动物髁突表面轮廓随随访时间的延长出现明显变化;这些变化似乎部分是可逆的。最显著的观察结果是髁突软骨前部和髁突下骨出现不规则和吸收。此外,在最初两周,吸收区域有大量破骨细胞和慢性炎症细胞侵入,在第3周和第4周后期数量减少,并被成骨活动所取代。

结论

这些实验数据表明,每天3毫米的牵张速率可能在牵张后的第1周和第2周导致TMJ髁突软骨发生退行性甚至早期关节炎改变。然而,在接下来的第3周和第4周,所有髁突均显示出适应性和重塑迹象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a33c/2581538/11df0cb1113e/TODENTJ-2-103_F1.jpg

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