Nogami Shinnosuke, Takahashi Tetsu, Ariyoshi Wataru, Yoshiga Daigo, Morimoto Yasuhiro, Yamauchi Kensuke
Division of Oral and Maxillofacial Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kitakyushu, Japan.
J Oral Maxillofac Surg. 2013 Jun;71(6):1050-8. doi: 10.1016/j.joms.2013.01.021.
The aim of the present study was to investigate the relation between magnetic resonance (MR) evidence of joint effusion and concentrations of proinflammatory cytokines, including interleukin (IL)-1β and IL-6, in washed-out synovial fluid samples obtained from patients with mandibular condyle fractures.
Twenty-five joints in 23 patients with mandibular condyle fractures were examined. Computed tomography was used to determine the position of the fracture and MR examination was performed in all cases. Twenty-five joints underwent temporomandibular joint (TMJ) irrigation before surgical treatment for the fractures. The detection rates and concentrations of the tested cytokines were determined, and their relations to evidence of joint effusion and positions of the condylar fractures were analyzed.
Six TMJ fractures were found in the head, 10 in the upper neck, 4 in the lower neck, and 5 in the subcondyle. MR evidence of joint effusion was observed in 17 of 25 TMJs (68.0%). The detection rate and concentration of IL-6 were significantly higher in patients with MR evidence of joint effusion and those with high condylar fractures. Moreover, there was a correlation between joint effusion grade and IL-6 concentration.
The present findings showed a correlation between MR evidence of joint effusion and concentration of IL-6 in washed-out synovial fluid samples collected from patients with mandibular condyle fractures. These results may provide support for arthrocentesis as a reasonable treatment modality for high condylar fractures.
本研究旨在探讨下颌髁突骨折患者冲洗后的滑液样本中,关节积液的磁共振(MR)证据与促炎细胞因子浓度之间的关系,这些促炎细胞因子包括白细胞介素(IL)-1β和IL-6。
对23例下颌髁突骨折患者的25个关节进行了检查。使用计算机断层扫描确定骨折位置,并对所有病例进行MR检查。在对骨折进行手术治疗前,对25个关节进行了颞下颌关节(TMJ)冲洗。测定了受试细胞因子的检出率和浓度,并分析了它们与关节积液证据及髁突骨折位置的关系。
发现6例TMJ骨折位于头部,10例位于上颈部,4例位于下颈部,5例位于髁突下。25个TMJ中有17个(68.0%)观察到关节积液的MR证据。在有MR关节积液证据的患者和髁突高位骨折患者中,IL-6的检出率和浓度显著更高。此外,关节积液分级与IL-6浓度之间存在相关性。
本研究结果表明,下颌髁突骨折患者冲洗后的滑液样本中,关节积液的MR证据与IL-6浓度之间存在相关性。这些结果可能为关节穿刺术作为髁突高位骨折的合理治疗方式提供支持。