EXPERIMENTAL STUDY ON THE PATHOPHISIOLOGY OF THE TEMPOROMANDIBULAR JOINT RELATED WITH THE PATHOGENESIS OF TEMPOROMANDIBULAR DISORDERS

本研究从以下四个方面对颞下颌关节紊乱病的发病机制进行了研究。本文采用有限元方法研究了正常牙合和错牙合患者颞下颌关节在牙合力作用下的力学行为。当颞下颌关节内产生异常的机械负荷时，提示骨发生了增加或吸收等改变。在下颌运动过程中，对人颞骨鳞状部分（下颌窝）的大脑表面进行应变测量。结果表明，在下颌运动过程中，不仅关节盘而且下颌窝上壁的骨对力产生缓冲作用。在下颌运动过程中检查颞下颌关节上级方面的关节内压力。结果表明，颞下颌关节具有泵血功能。因此，该功能在血管系统和关节软骨之间的营养交换中起重要作用。用电镜观察双侧磨牙缺失对颞下颌关节滑膜的影响。24个月时，颞下颌关节滑膜的细胞间隙被成熟的胶原蛋白紧密填充。

In this study, the following four aspects on the pathophisiology of the temporomandibular joint related with the pathogenesis of temporomandibular disorders were researched. A study was made of the mechanical behavior of the temporomandibular joint under occlusal force in normal occlusion or malocclusion using finite element method. When the abnormal mechanical loading was produced in the temporomandibular joint, it was suggested that the bony changes such as addition or absorption occurred. Strain measurements were taken on the cerebral surface of the squamous part of human temporal bone (mandibular fossa) during mandibular movements. It was suggested that during mandibular movements a buffer effect on the forces is produced not only by the articular disc but also by the bone of the upper wall of the mandibular fossa. Intraarticular pressure within the superior aspect of the temporomandibular joint was examined during mandibular movements. It was revealed that the temporomandibular joint had the pumping function. Thus, this function plays an important role in the nutritional exchange between the vascular system and the articular cartilage. The effect of loss of bilateral molars on the temporomandibular joint synovium was examined by electron microscopy. At 24 months, the intercellular space of the synovium was tightly filled with mature collagen in the temporomandibular joint.