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最大张口度与模拟颞下颌关节骨强直中骨性融合面积的相关性。

Association between maximum mouth opening and area of bony fusion in simulated temporomandibular joint bony ankylosis.

机构信息

State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases and Shaanxi Clinical Research Centre for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an, China.

Department of Stomatology, Xi'an Medical University, Xi'an, China.

出版信息

Int J Oral Maxillofac Surg. 2020 Mar;49(3):369-376. doi: 10.1016/j.ijom.2019.06.030. Epub 2019 Jul 16.

DOI:10.1016/j.ijom.2019.06.030
PMID:31320176
Abstract

The aim of this study was to investigate the quantitative association between active/passive maximum mouth opening (AMMO/PMMO) and the severity of simulated temporomandibular joint (TMJ) bony ankylosis. Twenty-eight male sheep were divided randomly and equally into surgical and control groups. Surgical group animals underwent bilateral TMJ osteotomy during which left lateral pterygoid muscle function was blocked. Control animals did not undergo surgery. Body weight, AMMO/PMMO, and TMJ morphological features were evaluated preoperatively and at 12 and 24 weeks post-surgery. In the surgical group, only the right TMJ complexes with maintained lateral pterygoid muscle function developed TMJ bony ankylosis. The AMMO/PMMO and end-feel distance in the surgical group were significantly lower than those in the control group (P < 0.001, both) at 12 and 24 weeks post-surgery. Moreover, AMMO (r = -0.940 and -0.952, P < 0.001, both) and PMMO (r = -0.944 and -0.953, P < 0.001, both) were negatively correlated with the area (mm) of bony fusion post-surgery. These findings may be useful for the clinical treatment of early mandibular condyle fracture, with the use of occlusal pads/open-mouth plates to relax the lateral pterygoid muscle and block its function. When bony ankylosis developed in the TMJ, the greater the area of bony fusion, the more limited were AMMO/PMMO.

摘要

本研究旨在探讨主动/被动最大张口度(AMMO/PMMO)与模拟颞下颌关节(TMJ)骨性强直严重程度之间的定量关系。28 只雄性绵羊被随机均分为手术组和对照组。手术组动物行双侧 TMJ 切开术,同时阻断左侧翼外肌的功能。对照组动物不接受手术。术前及术后 12 周和 24 周评估体重、AMMO/PMMO 和 TMJ 形态特征。在手术组中,只有右侧 TMJ 复合体伴保留的翼外肌功能发生 TMJ 骨性强直。手术组在术后 12 周和 24 周时的 AMMO/PMMO 和末端感觉距离明显低于对照组(P<0.001,均)。此外,AMMO(r=-0.940 和-0.952,P<0.001,均)和 PMMO(r=-0.944 和-0.953,P<0.001,均)与术后骨融合面积(mm)呈负相关。这些发现可能对临床治疗早期下颌骨髁突骨折有用,使用咬合垫/张口板来放松翼外肌并阻断其功能。当 TMJ 发生骨性强直时,骨融合面积越大,AMMO/PMMO 受限越明显。

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