下颌骨髁状突即刻再植的实验研究

An experimental study of the immediate replantation of the mandibular condyles

为髁状突即刻再植的临床应用提供理论依据。方法 以日本大耳白兔为实验对象 ,切下右侧髁状突后行即刻再植术。左侧作为对照。术后分期处死动物 ,观察骨的愈合、髁状突及关节盘形态和组织学的改变。结果 再植髁状突骨愈合良好。再植髁状突早期有异常的形态学的改变 ,其生长发育受到一定的影响 ,但无关节粘连和强直 ,所有动物可行使正常的咀嚼功能。结论 髁状突即刻再植术可选择性地用于颞下颌关节重建。

Objective To offer reference for the clinical application of the immediate replantation of the mandibular condyles. Methods Twenty four Japanese rabits were used in this study. The right mandibular condyle of every animal was resected and replanted immediately. The left side of condyle, which did not receive operation, served as control. Six animals were killed seperatively at 2, 4, 8, 12 weeks postoperatively. Clinical mor phological and histological examinations were conducted on the condyles and meniscuses of all experimental animals to evaluate the effects of the changes in them on the functions of the temporomandibular joints. Results The results showed that all the replanted condyles were revascularized rapidly and none of the condyles were lost as result of aseptic necrosis. The operated condyles became smaller than the controls. Slight degree of facial asymmetry and bifid mandibular condyles were observed in some animals. However, there were no articular adhesion and ankylosis. All animals could masticulate normally. Conclusion Therefore,the operative method of condylar replantation may be selectively applied to reconstruction of the temporomandibular joints.