Sahoo Nandakishore, Boruah Dibyajyoti, Thakral Ankur, Kumar Rahul, Roy Indranil Deb
Department of Oral and Maxillofacial Surgery, CMDC (CC), Lucknow, Uttar Pradesh 226002 India.
2Department of Pathology, Armed Forces Medical College, Pune, Maharashtra 411040 India.
J Maxillofac Oral Surg. 2018 Jun;17(2):248-253. doi: 10.1007/s12663-017-1051-6. Epub 2017 Oct 16.
Temporomandibular joint (TMJ) ankylosis is one of the most disruptive maladies afflicting the masticatory system. The characteristic feature is the formation of bony mass bridging condyle with glenoid fossa. The exact pathogenesis is, however, not completely understood.
To investigate and compare histomorphometric features of ankylosed condylar specimen with normal condylar process.
Group I included 17 post-traumatic unilateral TMJ ankylosis patients managed by excision of ankylosed mass and interpositional arthroplasty. Group II included 13 condylar head fracture patients managed by surgical debridement. The bony specimens of both the groups were subjected to histomorphometric examination for assessment of percentage of bone in trabeculae area (%BONE), osteocyte cell density (OSTCD), the presence of inflammation and fibrosis.
The mean %BONE, OSTCD, %inflammation, %fibrosis was 60.4%, 340.9 mm, 52.9 and 58.8% in group I and 29.6%, 202.6 mm, 31 and 0% in group II. %BONE, OSTCD and fibrosis in cases of TMJ ankylosis were significantly higher than the controls while no significant difference was observed in the presence of inflammation.
The persistence of joint inflammation following condylar head fracture causes aggressive reparative process leading to ankylosis.
颞下颌关节（TMJ）强直是困扰咀嚼系统的最具破坏性的疾病之一。其特征性表现是形成连接髁突与关节窝的骨块。然而，确切的发病机制尚未完全明确。
研究并比较强直髁突标本与正常髁突的组织形态计量学特征。
第一组包括17例创伤后单侧TMJ强直患者，采用切除强直块和间置物关节成形术治疗。第二组包括13例髁突头骨折患者，采用手术清创治疗。对两组的骨标本进行组织形态计量学检查，以评估小梁面积骨百分比（%BONE）、骨细胞密度（OSTCD）、炎症和纤维化情况。
第一组的平均%BONE、OSTCD、炎症百分比、纤维化百分比分别为60.4%、340.9mm、52.9%和58.8%，第二组分别为29.6%、202.6mm、31%和0%。TMJ强直病例的%BONE、OSTCD和纤维化显著高于对照组，而炎症情况无显著差异。
髁突头骨折后关节炎症持续存在会导致侵袭性修复过程，进而导致强直。
