夹板治疗髁状突纵形骨折对颞下颌关节血流影响的研究

Effects of Occlusal Splint Treatment on the Blood Flow ofTemporomandibular Joint after Sagittal Fracture of Mandibular Condyle

目的：观察髁状突纵形骨折后及夹板治疗时双侧颞下颌关节区的血流情况。探讨夹板治疗机制。材料和方法：中国实验用小型猪１４头，分为髁状突纵形骨折未治疗组、夹板治疗组及正常对照组。分别于髁状突纵形骨折后２、３、４、１２周做核素三相骨扫描检查。结果：髁状突纵形骨折侧颞下颌关节（Ｔｅｍｐｏｒｏｍａｎｄｉｂｕｌａｒｊｏｉｎｔ，ＴＭＪ）血流相的时间－放射性强度曲线改变大，峰值升高，峰时后延，以２周时最为明显，夹板治疗组各时间点均较未治疗组的ａ／β比值高。骨折侧血池相及延迟相计数比值升高，骨折后２周最高，然后逐渐下降。延迟相计数比值在夹板治疗组较未治疗组高。结论：夹板治疗髁状突纵形骨折有利于骨折后的血供，可能的作用机制是夹板减轻关节内及骨内压力，减轻静脉瘀血。

Purpose: To observe the effects of occlusal splint treatment on the bloodflow in TMJ region after SFMC and to explore the mechanism of the occlusal splint treatment. Materials and Methods: 14 miniature pigs were divided into 3 groups:untreated,occlusal splint treatment after SFMC and control group. Three-phase bone scintigraphy were performed on these pigs at different time. Results: The data showed the index of the time-activity curve from blood flow phase increased and blood flow arriving time was postponed after SFMC.The a/ ratio rose its peak value at 2 weeks after SFMC.The a/ ratio was higher after occlusal splint treatment.The count radio from blood pool and static phase was higher than nonfractured sides.The peak value were present at 2weeks after fracture. Conclusion: Occlusal splint treatment can improve blood supply after SFMC.The possible mechanism is reduction of the intraarticular pressure and blood stasis in bone marrow.