口腔疾病防治 ›› 2021, Vol. 29 ›› Issue (12): 793-800.DOI: 10.12016/j.issn.2096-1456.2021.12.001

• 专家论坛 • 上一篇    下一篇

创伤性颞下颌关节强直发病机制研究新进展

胡开进(),马振,王一名,邓天阁()   

  1. 军事口腔医学国家重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病临床医学研究中心,第四军医大学 口腔医院颌面外科,陕西 西安(710032)
  • 收稿日期:2021-05-06 修回日期:2021-06-15 出版日期:2021-12-20 发布日期:2021-08-17
  • 通讯作者: 胡开进,邓天阁
  • 基金资助:
    国家自然科学基金项目(81970954)

New progress in the pathogenesis of traumatic temporomandibular joint ankylosis

HU Kaijin(),MA Zhen,WANG Yiming,DENG Tiange()   

  1. State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Air Force Medical University, Xi’an 710032, China
  • Received:2021-05-06 Revised:2021-06-15 Online:2021-12-20 Published:2021-08-17
  • Contact: Kaijin HU,Tiange DENG
  • Supported by:
    National Natural Science Foundation of China(81970954)

摘要:

创伤性颞下颌关节强直是指外伤引起的髁突与颞骨关节窝之间的纤维性或骨性融合,可导致患者张口受限、咀嚼困难,甚至阻塞性睡眠呼吸暂停低通气综合征。当儿童或青少年发生创伤性颞下颌关节强直,还会导致面部发育不对称、小颌畸形、咬合关系错乱等,严重影响患者身心健康。该病一旦发生则治疗困难、易复发,而且发病机制不清,一直是口腔颌面外科研究的热点和难点。本文结合国内外最新的研究进展,明确创伤性颞下颌关节强直的发病因素,如髁突的损伤、关节盘的损伤或移位、关节窝的损伤以及翼外肌的类牵张成骨作用;对“血肿机化”、“翼外肌类牵张成骨”等发病机制假说进行述评,并结合相关细胞学和分子生物学研究阐述现阶段创伤性颞下颌关节强直的发病机制研究进展。

关键词: 创伤, 颞下颌关节, 关节强直, 发病机制, 髁突, 关节盘, 关节窝, 翼外肌, 动物模型, 间充质干细胞, 巨噬细胞

Abstract:

Traumatic temporomandibular joint ankylosis refers to fibrous or bony fusion between the condyle and the glenoid fossa. It can cause problems with mouth-opening limitations, mastication difficulties, obstructive sleep apnea and hypopnea syndrome. When traumatic temporomandibular joint ankylosis occurs during childhood, it can cause facial asymmetry, micrognathia, and malocclusion, which significantly affect the physical and mental health. Once temporomandibular joint ankylosis occurs, it will be refractory and recurrent. The pathogenesis of temporomandibular joint ankylosis has not been completely elucidated and has always been a research hotspot in the oral and maxillofacial fields. In this paper, worldwide research was conducted, and the pathogenesis of traumatic temporomandibular joint ankylosis was clarified, such as “damage of condyle”,“disc displacement or rupture”,“damage to the glenoid fossa” and “lateral pterygoid muscle distraction”. The relative pathogenesis hypotheses were summarized, such as “hematoma organization” and “lateral pterygoid muscle distraction osteogenesis”. The related pathogenesis of traumatic temporomandibular joint ankylosis was discussed based on the latest cytology and molecular biology research.

Key words: trauma, temporomandibular joint, ankylosis, pathogenesis, mandibular condyle, articular disc, glenoid fossa, lateral pterygoid muscle, animal model, mesenchymal stem cells, macrophages

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