带软骨肋骨行颞颌关节区移植后生长及其影响因素的动物实验

Experimental study on autotransplantation of costochondral graft in the defects in temporomandibular joint

目的 :研究自体带软骨肋骨游离移植后的生物学行为及其影响因素。方法 :3月龄新西兰白兔 2 0只随机分成 4组 :A ,B切除左侧关节盘 ,髁状突并下颌支 10mm后行自体带软骨肋骨移植关节成形术 ,A组软骨长 4mm ,B组 1mm。C组为手术对照 ,D组为健康对照 ,术后 4、6周分期处死进行X线及组织学检查。结果 :X线测量B、C组患侧下骨高度明显小于健侧 (P <0 .0 5)。组织学检查显示软骨增殖细胞接近软骨末端关节面 ,关节面有致密的平行排列的胶原纤维覆盖。结论 :自体带软骨肋骨颞颌关节区移植后保持了生长的趋势 ,软骨头改建为髁突类似结构 。

Objective: To observe the effects of autotransplantatio n of costochondral graft in the defects in temporomandibular joint. Methods: Twenty New Zealand white rabbits aged 3 months were div ided into 4 groups: the animals in group A received autotransplantation of 4 mm costochondral graft and in group B received that of 1 mm after excision of the disk, condyle and upper part of the ramus. The rabbits in group C received the same excision operation without graft transplantation as surgical controls and those in group D were used as healthy controls. Samples of temporomandibula r joint were obtained and examined by X-ray cephalometry and histopathology. Results: Cephalometric measurements revealed that height of the mandibles on left side was significantly shorter than that on right sid e in group B and C(P<0.05). Histological examination showed that prolifero us cells were close to the new articular surface of the cartilage end, the surf aces were covered with dense, parallel connective fibers and the grafts were fu sed by bone trabecula with the mandibles. Conclusion: Aut otransplanted costochondral graft into TMJ area keeps growth tendency and the c artilage end can be remodeled like condylar structure. Longer cartilaginous en d of the graft may be beneficial for growth tendency.