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[猕猴颞下颌关节盘后结缔组织折叠术愈合过程的实验研究]

[Experimental studies on healing process of plication technique at postdiscal connective tissue of TMJ in Macaca fuscata].

作者信息

Hayashi N

机构信息

2nd Department of Oral and Maxillofacial Surgery, Tokyo Dental College.

出版信息

Shikwa Gakuho. 1990 Aug;90(8):1037-55.

PMID:2134980
Abstract

The purpose of this study is to evaluate the healing process following application of the plication technique at the postdiscal connective tissue of the temporomandibular joint (TMJ). Female monkeys (Macaca fuscata) approximately eight years old were subjected to bilateral TMJ operations. The plication technique was performed in the left joint of each animal. In the right TMJ, the only operation performed was the exposure of the upper joint cavity. Results. 1) No synovial cells occurred on any upper surfaces of postdiscal connective tissue in left, first-week, postsurgical specimens. No synovial cells were observed in the area from the lateral to the middle upper surface of postdiscal connective tissues in specimens taken from the control side. Synovial cells gradually regenerated from the outside and, by the fourth postsurgical week, all of them had recovered in specimens from both sides. 2) During the early period, fibrin precipitation, round cell infiltration, fibroblast proliferation, and vascularization occurred in the plicated region. But these symptoms gradually decreased; and, by the twenty-fourth postsurgical week, collagen fibers surrounded the sutures. In the upper cavity, sutures were covered by newly proliferated connective tissue four weeks after surgery. The giant cells that proliferated around sutures in the fourth week increased gradually. 3) From the first postsurgical week, connective tissue proliferated in the lateral and middle parts of the superior postdiscal connective tissue in the right joint. Similar proliferation occurred in the left joint in the inner side of plicated region. Round cell infiltration took place in these connective tissue in the early period but gradually decreased. As this occurred, numbers of fat cells increased. No significant difference was noticed between proliferation in the right and left joints. No adhesion to the synovium in the glenoid fossa was observed. 4) In the first postsurgical week, connective tissue proliferated bilaterally from the posterior edges of both the glenoid fossa and the postdiscal tissue. In the second and fourth postsurgical weeks, connective tissue proliferation formed a fold narrowing the upper joint cavity. 5) Synovial cells were absent from the lateral to the middle region of both glenoid fossa from the first postsurgical week. Regeneration took place from the outside, and all synovial cells had recovered by the fourth postsurgical week. Disappearance of synovial cells was more extensive in the left than in the right glenoid fossa. 6) Round cell infiltration, vascularization, collagen fiber hyalinization, and hyperplasia of the fibrous covering occurred in the lateral part of the fibrous covering of the glenoid fossa but gradually decreased.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

本研究的目的是评估颞下颌关节(TMJ)盘后结缔组织应用折叠技术后的愈合过程。选用约8岁的雌性猕猴(食蟹猴)进行双侧TMJ手术。在每只动物的左侧关节实施折叠技术。在右侧TMJ,仅进行了上关节腔暴露手术。结果:1)在术后第一周的左侧手术标本中,盘后结缔组织的任何上表面均未出现滑膜细胞。在取自对照侧的标本中,从盘后结缔组织外侧至上中部表面区域均未观察到滑膜细胞。滑膜细胞从外侧逐渐再生,至术后第四周,两侧标本中的滑膜细胞均已恢复。2)在早期,折叠区域出现纤维蛋白沉淀、圆形细胞浸润、成纤维细胞增殖和血管化。但这些症状逐渐减轻;至术后第二十四周,胶原纤维围绕缝线。在上腔,术后四周缝线被新增殖的结缔组织覆盖。第四周在缝线周围增殖的巨细胞逐渐增多。3)从术后第一周开始,右侧关节上盘后结缔组织外侧和中部的结缔组织开始增殖。左侧关节折叠区域内侧也出现类似增殖。早期这些结缔组织中有圆形细胞浸润,但逐渐减少。与此同时,脂肪细胞数量增加。右侧和左侧关节的增殖情况未发现显著差异。未观察到与关节盂滑膜的粘连。4)在术后第一周,关节盂和盘后组织后缘双侧结缔组织均有增殖。在术后第二周和第四周,结缔组织增殖形成褶皱,使上关节腔变窄。5)从术后第一周开始,双侧关节盂外侧至中部区域均无滑膜细胞。滑膜细胞从外侧再生,至术后第四周所有滑膜细胞均已恢复。左侧关节盂滑膜细胞消失比右侧更广泛。6)关节盂纤维覆盖层外侧出现圆形细胞浸润、血管化、胶原纤维玻璃样变和纤维覆盖层增生,但逐渐减轻。(摘要截选至400字)

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