Clinical and Experimental Research on Indication, Effect and Complication of Temporomandibular Joint Arthroscopy

颞下颌关节镜手术的适应症、疗效及并发症的临床与实验研究

• 批准号: 08457559
• 负责人: SEGAMI Natsuki
• 金额: $ 4.67万
• 依托单位: Kanazawa Medical University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08457559/
• 关键词: Arthroscopy; Temporomandibular joint; Indication; Effect; Complication; Clinical study; Experimental study; 顎関節症; 関節鏡視法; 動物実験; 臨床研究

1. Clinical Research(1) Diagnostic ArthroscopyIn comparison of arthroscopic findings and clinical signs and symptoms in 50 cases with internal derangements of the temporomandibular joint (TMJ), 2 arthroscopic features were demonstrated the statistically negative correlations between the degeree of adhesion and maximum opening mouth, and the degree of synovitis and visual analogue scale of arthralgia. In artliroscopic examination in 16 TMJs of 11 cases with habitual luxation, typical feature of bulging of the articular eminence was detected, which was interpreted as one of the main etiology.(2) Arthroscopic SurgeryRetrospective analysis of 123 TMJs in 100 cases with closed lock, who underwent arthroscopic lysis and lavage, the averaged interincisal opening degree increased from 31.3mm to 42.7mm, and 106 TMJs with more than moderate degree of arthralgia recovered into disappeared in 81 joints and mild in 35 joints, at averaged follow-up period with 9.7 months. The overall success rate was 95.9% without significant complication.2. Experimental Research(1) Diagnostic ArthroscopyHistologic examination following diagnostic arthroscopy in 10 sheep TMJs, synovial hyperplasia and subsynovial bone remodeling of the mandibular fossa were observed through 2 weeks to 3 months postoperatively. Although, the cartilage regeneration did not completed, there was no further degenerative change.(2) Arthroscopic SurgeryHistologic examination following antero-lateral capsular release in 10 sheep TMJs, the anterior capsule cut by electric cautery showed fibrous hyperplasia at 1 week after surgery, and completed the almost healing process at 3 weeks postopratively associated with mild scar.The postoperative process after arthroscopic eminoplasty in 20 sheep TMJs revealed onset of healing with synovial hyperplasia and fibrous hyperplasia in the cancellous bone, however, incomplete regeneration of cartilage of the eminence was still observed at 3 months postoperative period

1.临床研究（1）诊断性关节镜检查通过对50例颞下颌关节内紊乱病患者的关节镜检查结果与临床症状、体征的比较，发现关节内粘连程度与最大张口度、滑膜炎程度与关节疼痛视觉模拟评分呈显著负相关。关节镜检查11例16个颞下颌关节习惯性脱位，均发现关节隆起的典型特征，认为是其主要病因之一。(2)关节镜手术回顾性分析100例闭合性交锁患者123个颞下颌关节，经关节镜下松解灌洗，平均切缘开放度由31.3mm增加到42.7mm，106个中度以上关节疼痛的颞下颌关节平均随访9.7个月，其中81个关节疼痛消失，35个关节疼痛减轻。总体成功率为95.9%，无明显并发症。2.实验研究（1）诊断性关节镜检查对10只绵羊颞下颌关节进行诊断性关节镜检查，观察术后2周~ 3个月滑膜增生及滑膜下骨改建情况。虽然软骨再生没有完成，但没有进一步的退行性变化。(2)关节镜下手术10只绵羊颞下颌关节前外侧囊松解后的组织学检查，术后1周电灼法切割的前囊显示纤维增生，20只羊关节镜下颞下颌关节成形术后，滑膜增生，松质骨纤维增生，骨，但在术后3个月仍观察到隆起软骨的不完全再生

项目成果

Segami, N., Kaneyama, K., Tsurusako, S., Suzuki, T.: "Arthroscopic eminoplasty for habitual luxationof the temporomandibular joint ; a preliminary study" J Cranio-Maxillofacial Surgery. (Submitted for publication). (1999)

Segami, N.、Kaneyama, K.、Tsurusako, S.、Suzuki, T.：“关节镜下颌骨成形术治疗颞下颌关节习惯性脱位；初步研究”J Cranio-Maxillofacial Medicine。

Murakami, K.: "Short-term treatment outcome study for the management of temporomandibular joint closed lock." Oral Surgery Oral Medicine Oral Pathology. 80. 253-257 (1995)

Murakami, K.：“颞下颌关节闭合锁管理的短期治疗结果研究。”

Segami, N.: "Treatment of Habitual Luxation of the Temporomandibular Joint" Jpn.Medical Journal. 3813. 33-36 (1997)

Segami, N.：“颞下颌关节习惯性脱位的治疗”Jpn.Medical Journal。

Fujita, S.: "Transforming growth factor and tenascin in chondromatosis of the IMJ." International J Oral Maxillofacial Surgery. 26. 258-259 (1997)

Fujita, S.：“IMJ 软骨瘤病中的转化生长因子和腱生蛋白。”

瀬上, 夏樹: "習慣性顎関節脱臼の治療" 日本醫事新報. 3813. 33-36 (1997)

Segami, Natsuki：“习惯性颞下颌关节脱位的治疗”日本医学报纸 3813. 33-36 (1997)。