Macroscopic and Histologic Analysis of Abdominal Dermis-Fat Grafts Retrieved From Human Temporomandibular Joints
Macroscopic and Histologic Analysis of Abdominal Dermis-Fat Grafts Retrieved From Human Temporomandibular Joints
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DOI：
10.1016/j.joms.2011.01.048
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发表时间：
2011-09-01
影响因子：
1.9
通讯作者：
Dimitroulis, George
中科院分区：
文献类型：
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作者：
Dimitroulis, George
目的：本研究的目的是在宏观和组织学水平上检查植入人颞下颌关节（TMJ）的腹部真皮脂肪移植物的命运。颞下颌关节椎间盘切除真皮脂肪移植术123例临床分析（2000年至2009年）进行了审查，并确定了8例患者谁有真皮脂肪移植手术从他们的颞下颌关节在随后的手术。在宏观和组织学水平上评估取出的移植物的大小、稠度和细胞组成。真皮脂肪移植物在初次植入TMJ.Results后8 ~ 46个月（平均22.3个月）取出，移植物材料呈橡胶状，充满了髁突头和关节窝/关节隆起之间的整个关节间隙。取出的移植物的平均尺寸为16 mm x 14 mm x 7 mm，平均体积尺寸为1.57 +/- 0.38 cm（3）。从所有关节中取出的间置组织显示出成熟脂肪组织的明确组织学证据，其中散布有萎缩的真皮成分，如汗腺和毛囊。脂肪/非脂肪组织的比例（平均值31.3% ± 5.7%）显著（P <0.01）低于原始移植物（平均值90.2% ± 6.3%）。没有证据表明，皮样囊肿或坏死脂肪在任何的标本examined.Conclusion：本研究的结果表明，腹部真皮脂肪移植到颞下颌关节茁壮成长，适应范围很好的关节腔，允许功能运动的关节。然而，在本研究中，真皮脂肪移植物未能保护髁突免受进一步恶化的6.5%的患者谁继续进行全关节置换。(C)2011年美国口腔颌面外科医师协会J Oral Maxillofac Surg 69：2329-2333，2011
Purpose: The purpose of the present study was to examine the fate of the abdominal dermis-fat grafts that were implanted into human temporomandibular joints (TMJ) at the macroscopic and histologic levels.Patients and Methods: The clinical records of 123 patients who underwent TMJ discectomy with dermis-fat grafting during a 10-year period (2000 to 2009) were reviewed, and 8 patients were identified who had had the dermis-fat graft surgically removed from their TMJ at a subsequent operation. The retrieved grafts were assessed at the macroscopic and histologic levels for size, consistency, and cellular composition. The dermis-fat grafts were retrieved after a period of 8 to 46 months (mean, 22.3) after initial implantation into the TMJ.Results: The graft material was a rubbery consistency and filled the entire joint space between the condylar head and glenoid fossa/articular eminence. The average size of the retrieved grafts was 16 mm x 14 mm x 7 mm, with a mean volumetric dimension of 1.57 +/- 0.38 cm(3). The interpositional tissue retrieved from all joints demonstrated clear histologic evidence of mature adipose tissue interspersed with dermal elements such as sweat glands and hair follicles that were atrophied. The ratio of fat/nonfat tissue was significantly (P < .01) less (mean, 31.3% +/- 5.7%) than in the original (mean, 90.2% +/- 6.3%) graft. No evidence was found of dermoid cysts or necrotic fat in any of the specimens examined.Conclusion: The results of the present study showed that abdominal dermis-fat grafts transplanted to the TMJ do thrive and adapt well to the confines of the joint cavity, allowing functional movement of the joint. However, in the present study, the dermis-fat graft failed to protect the condyle against additional deterioration in 6.5% of patients who went on to have total joint replacements. (C) 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69:2329-2333, 2011