Tuncel Umut, Kostakoglu Naci, Turan Aydın, Markoç Fatma, Gokçe Erkan, Erkorkmaz Unal
Department of Plastic Reconstructive and Aesthetic Surgery (Head: Prof. N. Kostakoglu, MD), Gaziosmanpasa University, Faculty of Medicine, 60100 Tokat, Turkey.
Department of Patology, Gaziosmanpasa University, Faculty of Medicine, 60100 Tokat, Turkey.
J Craniomaxillofac Surg. 2014 Dec;42(8):1868-76. doi: 10.1016/j.jcms.2014.07.005. Epub 2014 Aug 13.
The aim of the study was to evaluate the efficacy of temporalis muscle-fascia graft, fresh and cryopreserved human amniotic membrane as an interpositional material in preventing temporomandibular joint ankylosis in a rabbit model.
In this experimental study, 21 New Zealand white rabbits were used. The condyle and the joint disc were removed to induce ankylosis in left TMJs. Reconstruction was immediately performed with temporalis muscle-fascia graft (tMFG) in group I (n = 7), fresh human amniotic membrane (fHAM) in group II (n = 7) and cryopreserved human amniotic membrane (cHAM) in group III (n = 7). All rabbits were sacrificed at 3 months after the operation. The comparison was made among three groups by means of vertical mouth opening and weight measurements, radiologic and histologic findings obtained before and after surgery.
In all rabbits, there was no statistically significant difference in the jaw movements and weight among groups at commencement and 3 months after surgery. The condylar surfaces were more irregular in HAM groups. There were mild osteophyte formations, sclerosis, fibrosis and calcification around the condyle in all groups however the joint gap was more preserved in group I. All interpositional materials were also seen to be partially present in the joint gap at 3 months. Ankylosis was not seen in the joint gap in any group.
With the results of this study it was concluded that interpositional arthroplasty with HAM and tMFG have an almost similar effect in preventing TMJ ankylosis after discectomy in the rabbit model.
本研究旨在评估颞肌筋膜移植、新鲜和冷冻保存的人羊膜作为植入材料在兔模型中预防颞下颌关节强直的疗效。
在本实验研究中，使用了21只新西兰白兔。切除左侧颞下颌关节的髁突和关节盘以诱导强直。I组（n = 7）立即用颞肌筋膜移植（tMFG）进行重建，II组（n = 7）用新鲜人羊膜（fHAM），III组（n = 7）用冷冻保存的人羊膜（cHAM）。所有兔子在术后3个月处死。通过垂直开口度和体重测量、手术前后获得的放射学和组织学结果对三组进行比较。
在所有兔子中，术后开始时和3个月时，各组之间的下颌运动和体重没有统计学上的显著差异。羊膜组的髁突表面更不规则。所有组的髁突周围均有轻度骨赘形成、硬化、纤维化和钙化，然而I组的关节间隙保留得更好。在3个月时，所有植入材料在关节间隙中也均部分可见。任何组的关节间隙均未出现强直。
根据本研究结果得出结论，在兔模型中，羊膜和颞肌筋膜移植的植入性关节成形术在椎间盘切除术后预防颞下颌关节强直方面具有几乎相似的效果。
