Orthodontist, Cheyenne, Wyo.
Associate professor, Department of Pediatrics, Division of Rheumatology, College of Medicine, University of Nebraska Medical Center, Omaha, Neb.
Am J Orthod Dentofacial Orthop. 2015 Jan;147(1):80-8. doi: 10.1016/j.ajodo.2014.09.016.
Juvenile idiopathic arthritis in temporomandibular joints (TMJs) is often treated with intra-articular steroid injections, which can inhibit condylar growth. The purpose of this study was to compare simvastatin (a cholesterol-lowering drug that reduces TMJ inflammation) with the steroid triamcinolone hexacetonide in experimental TMJ arthritis.
Joint inflammation was induced by injecting complete Freund's adjuvant (CFA) into the TMJs of 40 growing Sprague Dawley rats; 4 other rats were left untreated. In the same intra-articular injection, one of the following was applied: (1) 0.5 mg of simvastatin in ethanol carrier, (2) ethanol carrier alone, (3) 0.15 mg of triamcinolone hexacetonide, (4) 0.5 mg of simvastatin and 0.15 mg of triamcinolone hexacetonide, or (5) nothing additional to the CFA. The animals were killed 28 days later, and their mandibles were evaluated morphometrically and with microcomputed tomography.
The analysis showed that the TMJs subjected to CFA alone had decreased ramus height compared with those with no treatment (P <0.05). Groups that had injections containing the steroid overall had decreases in weight, ramus height, and bone surface density when compared with the CFA-alone group (P <0.0001). Groups that had injections containing simvastatin, however, had overall increases in weight (P <0.0001), ramus height (P <0.0001), condylar width (P <0.05), condylar bone surface density (P <0.05), and bone volume (P <0.0001) compared with the groups receiving the steroid injections, and they were not different from the healthy (no treatment) group.
Treatment of experimentally induced arthritis in TMJs with intra-articular simvastatin preserved normal condylar bone growth.
颞下颌关节(TMJ)的幼年特发性关节炎常采用关节内类固醇注射治疗,这可能会抑制髁突生长。本研究旨在比较辛伐他汀(一种降低 TMJ 炎症的降胆固醇药物)和曲安奈德己酮在实验性 TMJ 关节炎中的作用。
40 只生长中的 Sprague Dawley 大鼠的 TMJ 内注射完全弗氏佐剂(CFA)以诱导关节炎;另有 4 只大鼠未接受治疗。在相同的关节内注射中,应用以下方法之一:(1)0.5mg 辛伐他汀在乙醇载体中,(2)单独的乙醇载体,(3)0.15mg 曲安奈德己酮,(4)0.5mg 辛伐他汀和 0.15mg 曲安奈德己酮,或(5)CFA 中不添加其他药物。28 天后处死动物,对其下颌骨进行形态计量学和微计算机断层扫描评估。
分析显示,与未治疗的动物相比,仅接受 CFA 的 TMJ 髁突高度降低(P<0.05)。与 CFA 单一组相比,接受含类固醇注射的各组体重、髁突高度和骨表面密度均降低(P<0.0001)。然而,接受辛伐他汀注射的各组体重总体增加(P<0.0001)、髁突高度(P<0.0001)、髁突宽度(P<0.05)、髁突骨表面密度(P<0.05)和骨体积(P<0.0001)均增加,与接受类固醇注射的各组相比,且与健康(未治疗)组无差异。
关节内辛伐他汀治疗 TMJ 实验性关节炎可保持正常的髁突骨生长。