国际口腔医学杂志 ›› 2019, Vol. 46 ›› Issue (1): 12-19.doi: 10.7518/gjkq.2019.01.003
Jun Guo1,Wei Fei1,Qinghua Li2()
摘要:
目的 在建立小型猪髁突囊内骨折动物模型的基础上,通过评价不同处理方式对髁突囊内骨折预后的影响,探索创伤性颞下颌关节强直发生的机制。方法 小型猪15只,随机分为3组,每组5只(10侧颞下颌关节),采用手术方法造成双侧髁突囊内骨折,切除前外侧部分关节盘;根据髁突骨折临床治疗常用方式,分别用钛板内固定、关节囊内注射生理盐水、观察其自然愈合3种处理方式治疗各组囊内骨折。术后6个月,通过大体标本观察、影像学和组织学检查评价各组颞下颌关节强直的形成;利用免疫组织化学染色、逆转录-聚合酶链反应(RT-PCR)和Western Blot技术检测各组颞下颌关节中血管内皮生长因子(VEGF)、骨钙素(OCN)、骨桥蛋白(OPN)和骨形态发生蛋白-2(BMP2)的mRNA和蛋白表达水平。结果 实验组颞下颌关节强直发生率显著低于自然愈合组(P<0.05),实验组颞下颌关节中VEGF、OCN、OPN和BMP2的mRNA和蛋白表达水平明显低于自然愈合组,差异有统计学意义(P<0.01)。结论 不同处理方式治疗髁突囊内骨折与创伤性颞下颌关节强直的发生率密切相关;清理骨创间血肿、减少骨创面的暴露及骨折碎片的复位是预防关节强直发生的关键因素。
中图分类号:
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