Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
Radiology Unit (Head: Radiology Technician. H Sakamoto), University of Yamanashi Hospital, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
J Craniomaxillofac Surg. 2019 Feb;47(2):320-327. doi: 10.1016/j.jcms.2018.11.034. Epub 2018 Dec 5.
The purpose of this study was to examine the effect of injecting basic fibroblast growth factor following surgical induced anterior disc displacement in temporomandibular joints (TMJ).
Adult male Japanese white rabbits (n = 16; 2.0-2.5 kg; 10 weeks old) were assigned to experimental and control groups. In the experimental group, anterior disc displacement was induced in the bilateral TMJ. Recombinant human basic fibroblast growth factor (rh bFGF) 0.1 μg/1 μL aqueous solution was injected into the left retro-discal connective tissue close to the disc (ADL group), and saline alone was injected into the same site on the right (ADR group). In the control group, a sham operation without disc position change was performed in the bilateral TMJ (CR group and CL group). Four animals from the experimental (ADR and ADL) and control (CR and CL) groups were sacrificed at 1 and 12 weeks postoperatively to evaluate the mandibular morphology and computed tomographic (CT) value of the condylar head, using 3 dimensional computed tomography. Furthermore, cartilage layers and disc tissue were examined histologically.
Regarding CT value at the 0° site of the condylar surface, ADR showed the lowest value after 1 week (P = 0.0325). However, there were no significant differences among the 4 groups regarding CT values at the other degree sites after 1 and 12 weeks. Regarding mandibular length, ADR showed the lowest value after 12 weeks (P = 0.0079). In condylar width, ADR showed the lowest value after 1 week (P = 0.0097).
This study suggested that surgically induced anterior disc displacement could affect condylar morphology in the early stage, and could decrease mandibular length in the late stage. However, bFGF injection into the TMJ might prevent the degenerative change derived from anterior disc displacement and inhibition of sequential mandibular growth.
本研究旨在探讨在颞下颌关节(TMJ)中注射碱性成纤维细胞生长因子(bFGF)对手术诱导的前盘移位的影响。
成年雄性日本白兔(n=16;2.0-2.5kg;10 周龄)被分为实验组和对照组。实验组双侧 TMJ 均行前盘移位。将 0.1μg/1μL 的重组人碱性成纤维细胞生长因子(rh bFGF)水溶液注入左侧关节盘后附着处(ADL 组),右侧相同部位注入生理盐水(ADR 组)。对照组双侧 TMJ 行假手术(CR 组和 CL 组),不改变盘位置。术后 1 周和 12 周,实验组(ADR 和 ADL)和对照组(CR 和 CL)各有 4 只动物处死,用三维 CT 评价下颌形态和髁突头的 CT 值。此外,还对软骨层和盘组织进行了组织学检查。
在髁突表面 0°位的 CT 值方面,ADR 在术后 1 周时最低(P=0.0325)。但在术后 1 周和 12 周时,其他角度的 CT 值在 4 组之间无显著差异。在下颌长度方面,ADR 在术后 12 周时最低(P=0.0079)。在髁突宽度方面,ADR 在术后 1 周时最低(P=0.0097)。
本研究表明,手术诱导的前盘移位可在早期影响髁突形态,晚期可导致下颌长度缩短。然而,TMJ 内注射 bFGF 可能预防前盘移位导致的退行性改变和继发的下颌生长抑制。