过度张口对颞下颌关节软组织P物质样免疫反应的影响

Effects of overextended mouth opening on substance P like immunologic reaction of TMJ soft tissues

目的深入探讨过度张口对颞下颌关节（ＴＭＪ）的损伤特点及其神经生物学机制。方法在对过度张口的组织病理学实验研究基础上，采用ＡＢＣ免疫组化法同步观察其ＴＭＪ软组织Ｐ物质样免疫反应（ＳＰＩＲ）的变化。结果过度张口主要使关节盘前伸部、双板区和关节囊滑膜下层ＳＰＩＲ显著增强，并随过度张口的延长而加重，去除刺激休息两周后，ＳＰＩＲ明显减弱。ＳＰＩＲ的变化与其组织病理学改变在变化部位、反应程度和治疗效果上基本一致，提示二者间确有某些内在联系。结论认识变化特点，把握内在联系，将有助于拓展ＴＭＪ损伤及疼痛的预防与诊治的思路及方法。

Objective To probe deeply into the traumatic characteristics and the neurobiologic mechanism of overextended mouth opening of the temporomandibular joint (TMJ). Methods Changes of the substance P like immunologic reaction (SPIR) of the TMJ soft tissues were examined with ABC immunohistochemical staining along with the histopathological study of the overextended opening. Results An obvious increase of SPIR brought about by overextended opening was mainly in the anterior extending tissue of the disc, the bilaminar zone and the subsynovial layer of the articular capsule, and the extent of the reaction became greater with the increased duration of over opening. The SPIR decreased obviously two weeks after removing the nocuous stimulation. The changes of SPIR almost coincided with the histopathological changes in sites and extents, and in the effects on them of the relevant treatment, which indicate that there are some internal relations between the two kinds of changes. Conclusion To recognize the characteristics of the changes and grasp the internal relations will help us to find new approaches to the prevention, diagnosis and treatment for the trauma and pain of the TMJ.