后牙缺失引起关节盘改建的组织学及免疫组化的研究

Histopathological and Immunohistochemical Study of the Discal Remodelling of Temporomandibular Joint Caused by Extraction of Molars.

目的 :研究一侧后牙缺失后双侧颞下颌关节关节盘细胞及细胞外基质的变化规律。方法 :拔除成年家兔左侧下颌磨牙 ,用免疫组化方法检测Ⅰ、Ⅱ、Ⅲ型胶原在术后 2周、1个月和 3个月双侧关节盘的分布及含量变化。结果 :非拔牙侧关节盘出现钙化、纤维化、血管侵入、形变等 ,而拔牙侧只有钙化、纤维走行改变 ;双侧Ⅰ、Ⅱ型胶原的表达均明显减少 ,并且Ⅰ型胶原出现不均衡分布 ;Ⅲ型胶原的表达术后明显增多 ,以非拔牙侧更明显。结论 :后牙缺失过久会导致成年家兔关节盘抗压抗拉特性下降 ,脆性增加 ;单侧后牙缺失时 。

Objective:To determine the characteristic of cells and extracellular matrix of disc of temporomandibular joint (TMJ) after loss of teeth.Methods:The left lower molars of adult rabbits were extracted,and immunohistochemical methods were used to determine the localization and quantities change of type Ⅰ and type Ⅱ and type Ⅲ collagen in the disc of both side after two weeks,one month and three months.Results:The disc of the non extraction side became fibrosis,calcified,vacularized and deformed;while the opposite disc only showed calcified and disoriented of the fiber.The expression of type Ⅰ and Ⅱ collagen decreased after the extraction of the teeth,furthermore type Ⅰ collagen distributed unevenly.The immunostaining for type Ⅲ collagen was stronger than the control group.All these changes were more obvious in the disc of non extraction side than in the opposite disc.Conclusion:The resistance and elasticity of disc in adult rabbits would impair after loss of the teeth for a long time, and the pathological changes of disc in the masticatory side were more obvious. [