Flygare L, Rohlin M, Akerman S
Department of Oral Radiology, Institute for Postgraduate Dental Education, Jönköping, Sweden.
Acta Odontol Scand. 1995 Oct;53(5):297-303. doi: 10.3109/00016359509005991.
Thirty-nine temporomandibular joint autopsy specimens were examined by microscopy and tomography for erosive changes. We found two types of erosive changes, an extensive type with complete loss of cartilage and a local type with retained articular cartilage. On microscopic examination nearly twice as many temporal components as condyles were eroded. The erosions were generally more extensive in the condyle. Erosions in the condyle were evenly distributed. In the temporal component there was a slight predominance of erosions located to the lateral part of the tubercle. The radiologic investigation underestimated both the presence and the extent of the erosions. Positive predictive values and negative predictive values were 0.70 and 0.83, respectively, for erosions in the condyle and 0.91 and 0.68 for erosions in the temporal component. It is suggested that the initial event in osteoarthrosis of the TMJ can occur as a subarticular hard-tissue change. The need for more accurate diagnostic tools than radiography should be stressed.
对39个颞下颌关节尸检标本进行了显微镜检查和断层扫描，以观察侵蚀性改变。我们发现了两种侵蚀性改变类型，一种是软骨完全缺失的广泛型，另一种是关节软骨保留的局部型。显微镜检查发现，颞骨部分的侵蚀数量几乎是髁突的两倍。侵蚀通常在髁突处更为广泛。髁突的侵蚀分布均匀。在颞骨部分，结节外侧部分的侵蚀略占优势。放射学检查低估了侵蚀的存在和程度。髁突侵蚀的阳性预测值和阴性预测值分别为0.70和0.83，颞骨部分侵蚀的阳性预测值和阴性预测值分别为0.91和0.68。提示颞下颌关节骨关节炎的初始事件可能表现为关节下硬组织改变。应强调需要比放射摄影更准确的诊断工具。
