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[自体肋软骨膜移植修复下颌骨髁突软骨的组织学研究]

[Histological study on the using of autogenous costal perichondrium graft to repair the cartilage of condylar process of mandible].

作者信息

Xie Z, Zhao W, Zheng X

机构信息

Department of Oral and Maxillofacial Surgery, Medical College of Dalian University, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 1997 Jul;11(4):199-202.

PMID:9867977
Abstract

In order to observe the histological changes of the autogenous perichondrium graft from rib in the repair of injured articular cartilage of the condylar process of mandible, 50 rabbits were used, in which 15 were served as control. The articular cartilage with its subchondral bone were resected and an autogenous graft of costal perichondrium was sutured onto the raw surface of the condylar process, and in the controls, only the articular portion of the condylar process was resected without the application of autogenous costal perichondrium graft. The morphological changes of the newly formed cartilage during the process of its development were investigated by hiostological and autoradiog aphic techniques. The result revealed that 10 days after operation, the graft had increased in thickness and was richly populated form the proliferation of mesenchyme-like cells. Twenty to thirty days later, the chondrocytes were matured and the newly formed cartilage had covered the bony surface of mandibular condyle. At 60 days, the newly formed cartilagenous joint surface became glossy, and the morphology and arrangement of cells tended to be regular simulating the morphology of normal articular cartilage. From the experiment, it could be concluded that (1) The autogenous perichondrium graft placed on the condylar surface of mandible could form new articular cartilage which was similar in tissue morphology to the normal condylar cartilage. (2) The process of development of newly formed cartilage was similar to that of the normal cartilage. (3) The motion and loading on the joint could promote the formation of new cartilage and undergo biological reformation, gradually resulting in normal joint morphology. On this basis, the clinical application of autogenous perichondrium graft to repair injured cartilage of the condylar process of the mandible was feasible.

摘要

为观察自体肋软骨膜移植修复下颌骨髁突关节软骨损伤的组织学变化,选用50只家兔,其中15只作为对照。切除关节软骨及其软骨下骨,将自体肋软骨膜移植缝合于髁突创面,对照组仅切除髁突关节部分,未行自体肋软骨膜移植。采用组织学和放射自显影技术研究新形成软骨在发育过程中的形态学变化。结果显示,术后10天,移植组织厚度增加,间充质样细胞增殖丰富。20至30天后,软骨细胞成熟,新形成的软骨覆盖了下颌髁突的骨面。60天时,新形成的软骨关节面变得光滑,细胞形态和排列趋于规则,类似正常关节软骨的形态。从实验中可以得出结论:(1)置于下颌髁突表面的自体肋软骨膜移植可形成组织形态与正常髁突软骨相似的新关节软骨。(2)新形成软骨的发育过程与正常软骨相似。(3)关节的运动和负荷可促进新软骨的形成并进行生物学改建,逐渐形成正常关节形态。在此基础上,自体肋软骨膜移植修复下颌骨髁突损伤软骨的临床应用是可行的。

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