Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun Nandajie, Haidian District, Beijing 100081, PR China.
Med Hypotheses. 2012 Feb;78(2):273-6. doi: 10.1016/j.mehy.2011.10.044. Epub 2011 Nov 23.
The traumatic temporomandibular joint (TMJ) bony ankylosis has generated great interest in the cranio-maxillofacial surgeons yet remains an enigma, due to its unknown pathogenesis. Organization and ossification of hematoma is the classical hypothesis concerning the underlying pathophysiology, but it could not explain all the unique characters of TMJ bony ankylosis. The previous imaging descriptions about bony ankylosis tend to over-emphasize the obliteration of joint space and the overgrowth of new bone around the joint. Our recent study has found that the radiolucent zone in the bony fusion area indicating impaired bone healing is one of the most important imaging features of bony ankylosis, and this imaging feature is similar to that of hypertrophic nonunion of long bone. We also observe that there is close relationship between the mouth opening and the degree of calcification of radiolucent zone. Therefore, we hypothesize that the development of traumatic TMJ bony ankylosis may be the course of bone healing of two injured articular surfaces under the interference of opening movement, which is similar to the hypertrophic nonunion. Our hypothesis could help to explain some unintelligible characters of bony ankylosis, and deserves further studies.
创伤性颞下颌关节（TMJ）骨强直引起了颅颌面外科医生的极大兴趣，但由于其发病机制不明，仍然是一个谜。血肿的组织和骨化是关于潜在病理生理学的经典假说，但它不能解释 TMJ 骨强直的所有独特特征。以前关于骨强直的影像学描述往往过于强调关节间隙的消失和关节周围新骨的过度生长。我们最近的研究发现，骨融合区的透亮带表明骨愈合受损，这是骨强直的最重要影像学特征之一，这种影像学特征类似于长骨的肥大性骨不连。我们还观察到，张口度与透亮带钙化程度之间存在密切关系。因此，我们假设创伤性 TMJ 骨强直的发展可能是两个受损关节表面在开口运动干扰下的骨愈合过程，类似于肥大性骨不连。我们的假设可以帮助解释骨强直的一些难以理解的特征，值得进一步研究。
