定量咬合干扰对颞下颌关节早期损伤的实验研究

The experimential study of initial temporomandibular joint injury induced by quantitative occlusal interferences

目的 研究咬合干扰及干扰的量对家兔颞下颌关节早期损伤的影响。方法 采用 0 .15mm、0 .18mm、0 .2 0mm厚的金属冠牙合板粘接于A、B、C三组家兔左下第一至第三磨牙牙合面形成咬合干扰 ,第三天处死家兔 ,取双侧颞下颌关节连续切片HE染色。光镜观察滑膜组织变化。结果 0 .15mm组家兔颞下颌关节的滑膜与空白对照组比较无明显变化 ;0 .18mm组滑膜变化以轻度渗出为主 ;0 .2 0mm组左侧滑膜变化除渗出外可见增生 ,右侧滑膜变化主要表现为渗出。结论 高于 0 .18mm厚的咬合干扰对家兔颞下颌关节能产生早期损伤 ,表现为滑膜渗出和增生性炎症反应 ,安装咬合干扰装置侧比对侧产生的反应重 ,病变部位主要在关节囊关节盘移行部滑膜。

Objective To investigate the influence of occlusal interferences and the degree of occlusal interferences on the trauma of temporomandibular joint synovial membrane.Methods Twelve 5-month old male healthy rabbits were divided into 4 groups (A,B,C and K),and treated by occlusion interferences with 0.15mm,0.18mm and 0.20mm metal splints respectively.All the treated animals were killed three days after adherence.Extracted bilateral temporomandibular joints (TMJ) were treated by HE staining and the changes of synovial membranes (SM) were observed by a light microscope.Results Compared with the control group,the changes of synovial membranes in group A were not significant.Slight exudation was the changes in the synovial membranes in group B.Major changes of left TMJ synovial membranes in group C were proliferation,whereas those of right TMJ synovial membranes were exudation.Conclusion Occlusal interference induced by 0.15mm thick splint does not cause the trauma of TMJ.The position of initial trauma of TMJ induced by occlusal interferences is located at the synovial membrane between intracapsule and the articular disc transition zone.