Ali A M, Sharawy M M
Department of Oral Biology, Medical College of Georgia, Augusta 30912-1122.
J Oral Pathol Med. 1994 Sep;23(8):364-74. doi: 10.1111/j.1600-0714.1994.tb00077.x.
Several studies have shown that anterior disk displacement (ADD) of human temporomandibular joint (TMJ) can lead to cellular and extracellular alterations in the disk proper, bilaminar zone (BZ), condyle, articular eminence and synovial membrane. Due to lack of an animal model for this disease, it is not known whether the mechanical displacement of the disk could lead to the observed histopathological changes. The purpose of this experiment was to investigate the histopathological changes that occur in the rabbit craniomandibular joint (CMJ) following surgical induction of ADD. The right CMJ was exposed surgically and the discal attachments were severed except for the BZ attachments. Then the disk was displaced anteriorly and sutured to the zygomatic arch. The left joint served as surgical control. The CMJs were removed after 24 h, 1 week, 2 weeks or 6 weeks and stained with H&E or modified Masson stain. The results showed neovascularization, cell clustering and fibrillation of the displaced disk. The BZ showed marked fibrosis. The condyle showed subchondral hemorrhage and fibrosis followed by osteoarthritic changes in the articular cartilage. The articular eminence showed chondrocytic clustering and an increase in the amount of chondroid bone. Synovial membrane exhibited marked hyperplasia. We concluded that surgical induction of ADD in the rabbit CMJ leads to cellular and extracellular alterations in the disk proper, BZ, condyle, articular eminence and synovial membrane similar to those described previously in human ADD. It appears that the mechanical trauma resulting from ADD could lead to a cascade of reparative and degenerative changes of the affected joints similar to those described for osteoarthritis.
多项研究表明，人类颞下颌关节（TMJ）的关节盘前移位（ADD）可导致关节盘本体、双板区（BZ）、髁突、关节结节和滑膜出现细胞及细胞外改变。由于缺乏该疾病的动物模型，尚不清楚关节盘的机械移位是否会导致所观察到的组织病理学变化。本实验的目的是研究兔颅下颌关节（CMJ）在手术诱导ADD后发生的组织病理学变化。通过手术暴露右侧CMJ，除双板区附着外切断关节盘附着。然后将关节盘向前移位并缝合至颧弓。左侧关节作为手术对照。在24小时、1周、2周或6周后取出CMJ，用苏木精-伊红（H&E）或改良马松染色。结果显示移位关节盘有新生血管形成、细胞聚集和纤维化。双板区显示明显纤维化。髁突显示软骨下出血和纤维化，随后关节软骨出现骨关节炎改变。关节结节显示软骨细胞聚集和类软骨骨量增加。滑膜表现出明显增生。我们得出结论，兔CMJ手术诱导ADD会导致关节盘本体、双板区、髁突、关节结节和滑膜出现细胞及细胞外改变，类似于先前在人类ADD中所描述的情况。似乎ADD导致的机械创伤可引发受影响关节一系列修复和退变变化，类似于骨关节炎中所描述的情况。
