颞下颌关节紊乱病与关节内压

doi:10.12016/j.issn.2096-1456.2018.02.001

口腔疾病防治 ›› 2018, Vol. 26 ›› Issue (2): 69–74.doi: 10.12016/j.issn.2096-1456.2018.02.001

• 专家论坛 • 下一篇

颞下颌关节紊乱病与关节内压

张志光(), 刘文静

中山大学光华口腔医学院·附属口腔医院口腔颌面外科,广东省口腔医学重点实验室,广东广州（510055）

收稿日期:2017-08-02 修回日期:2017-10-20 出版日期:2018-02-20 发布日期:2018-08-31
作者简介:

【通信作者简介】张志光,二级教授,一级主任医师,博士生导师。中山大学光华口腔医学院·附属口腔医院原副院长。现任口腔颌面外科课程负责人、颞下颌关节病诊治中心主任、中华口腔医学会颞下颌关节病学及颌学专业委员会主任委员、中华口腔医学会口腔颌面外科专业委员会副主任委员、广东省口腔医学会副会长、广东省口腔医学会口腔颌面外科专业委员会名誉主任委员、中国整形美容协会副会长兼口腔整形美容分会候任会长,广东省整形美容协会会长、广东省整形美容协会口腔整形美容分会主任委员;担任《中华口腔医学杂志》、《中华口腔医学研究杂志（电子版）》、《中国口腔颌面外科杂志》等杂志编委;先后主持国家自然科学基金2项、省部级科研项目10项、卫生部临床学科重点项目1项;获得国家专利12项及计算机软件著作权1项;在国内外发表学术论文180余篇,其中被SCI收录35篇;主编专著1部,副主编专著1部,参编专著12部;获国家教委科技进步三等奖1项,广东省科学技术进步奖二等奖2项,广东省科学技术奖一等奖1项。2008年获国际牙医师学院院士,2011年获中山大学教学名师,招收硕士研究生、博士研究生、博士后共56名。2014年被评为中山大学首届名医,2000年评为国务院特殊津贴专家。
基金资助:
国家自然科学基金项目（10972242）;卫生部临床重点项目（卫规财行[2010]439号）

Temporomandibular disorders and intra-articular pressure

Zhiguang ZHANG(), Wenjing LIU

Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China

Received:2017-08-02 Revised:2017-10-20 Online:2018-02-20 Published:2018-08-31

摘要/Abstract

摘要：

颞下颌关节是口腔颌面部咀嚼系统的枢轴关节,承担着口腔颌面部语言、咀嚼等复杂精细的功能运动。当颞下颌关节发生病理变化或者功能异常时,除了影像学、滑液的理化性质和生物因子的表达发生变化,关节内的压力数值也随之发生变化,并在一定程度上反映出颞下颌关节紊乱病的病理机制和病程。本文将作者课题组近30年来对正常及病理情况下颞下颌关节内压的变化规律相关研究,及其对颞下颌关节组织变化和生物力学的影响等进行阐述,以期为颞下颌关节紊乱病的临床诊疗提供新的思路。

关键词: 口腔, 颞下颌关节, 颞下颌关节紊乱病, 关节内压

Abstract:

Temporomandibular joint is the pivot joint system in oral and maxillofacial chewing system, bearing the intricate function such as speaking and chewing movement. During the process of derangement or functional impairment of temporomandibular joint, there are some changes in radiograph or the synovial fluid physical and chemical properties. Besides, the variation of intra-articular pressure also reflects the pathological mechanism and course of temporomandibular joint disorders. This article will review our related researches on intra-articular pressure of temporomandibular joint in the last 30 years, including the fluctuating rule, its significance of intra-articular pressure in TMJ and the effect of that on the joint physiopathology and biomechanics, to provide new ideas for clinical diagnosis and treatment of temporomandibular disorders.

Key words: Stomatology, Temporomandibular joint, Temporomandibular disorders, Intra-articular pressure

中图分类号:

R782.6

张志光, 刘文静. 颞下颌关节紊乱病与关节内压[J]. 口腔疾病防治, 2018, 26(2): 69–74.

Zhiguang ZHANG, Wenjing LIU. Temporomandibular disorders and intra-articular pressure[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2018, 26(2): 69–74.

图/表 2

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图2

参考文献 26

[1]	Israel HA.Internal derangement of the temporomandibular joint: new perspectives on an old problem[J]. Oral Maxillofac Surg Clin North Am, 2016, 28(3): 313-333.
[2]	Kuroda S, Tanimoto K, Izawa T, et al.Biomechanical and biochemical characteristics of the mandibular condylar cartilage[J]. Osteoarthritis Cartilage, 2009, 17(11): 1408-1415.
[3]	许跃, 陈缵光, 张志光, 等. 颞下颌关节内压力测量系统的研制[J]. 中华口腔医学研究杂志(电子版), 2008, 2(3): 245-248.
[4]	Zhang ZG, Xu Y, Zheng YH, et al.Measurement and classification of intra-articular pressure in the temporomandibular joint with anterior disc displacement without reduction[J]. Chin J Dent Res, 2002, 5(2): 34-38.
[5]	许跃, 张志光, 郑有华. 突发性严重绞锁颞下颌关节的压力测量和分析[J]. 华西口腔医学杂志, 2005, 23(1): 41-42.
[6]	张志光, 任材年, 陈光晔, 等. 正常成人颞下颌关节腔内压测量与分析[J]. 中山医科大学学报, 1995, 1(3): 57-60.
[7]	Xu Y, Zhan J, Zheng Y, et al.Synovial fluid dynamics with small disc perforation in temporomandibular joint[J]. J Oral Rehabil, 2012, 39(10): 719-726.
[8]	Xu Y, Zhan JM, Zheng YH, et al.Computational synovial dynamics of a normal temporomandibular joint during jaw opening[J]. J Formos Med Assoc, 2013, 112(6): 346-351.
[9]	Xu Y, Lin H, Zhu P, et al.A comparative study between use of arthroscopic lavage and arthrocentesis of temporomandibular joint based on computational fluid dynamics analysis[J]. PLoS One, 2013, 8(11): e78953.
[10]	张志光. 颞下颌关节紊乱病关节腔内压测量与关节镜外科[J]. 中华口腔医学杂志, 2004, 39(2): 168-170.
[11]	Lennon DP, Edmison JM, Caplan AI.Cultivation of rat marrow-derived mesenchymal stem cells in reduced oxygen tension: effects on in vitro and in vivo osteochondrogenesis[J]. J Cell Physiol, 2001, 187(3): 345-355.
[12]	Yang Z, Liu M, Zhang YG, et al.Effects of intermittent negative pressure on osteogenesis in human bone marrow-derived stroma cells[J]. J Zhejiang Univ Sci B, 2009, 10(3): 188-192.
[13]	Yang Z, Yao JF, Xu P, et al.Functions and mechanisms of intermittent negative pressure for osteogenesis in human bone marrow mesenchymal stem cells[J]. Mol Med Rep, 2014, 9(4): 1331-1336.
[14]	Baldwin C, Potter M, Clayton E, et al.Topical negative pressure stimulates endothelial migration and proliferation: a suggested mechanism for improved integration of Integra[J]. Ann Plast Surg, 2009, 62(1): 92-96.
[15]	Sun Z, Wang X, Ling M, et al.Acceleration of tendon-bone healing of anterior cruciate ligament graft using intermittent negative pressure in rabbits[J]. J Orthop Surg Res, 2017, 12(1): 60.
[16]	Liu W, Sun Y, He Y, et al.IL-1β impedes the chondrogenic differentiation of synovial fluid mesenchymal stem cells in the human temporomandibular joint[J]. Int J Mol Med, 2017, 39(2): 317-326.
[17]	郑卫平, 苏凯, 张志光, 等. 压力对体外培养下颌髁状突软骨细胞基质中蛋白多糖合成的影响[J]. 中山大学学报(医学科学版), 2006, 23(z1): 120-122.
[18]	Nitzan DW.Intraarticular pressure in the functioning human temporomandibular joint and its alteration by uniform elevation of the occlusal plane[J]. J Oral Maxillofac Surg, 1994, 52(7): 671-680.
[19]	Linsen SS, Reich RH, Teschke M.Pressure pain threshold and oral health-related quality of life implications of patients with alloplastic temporomandibular joint replacement--a prospective study[J]. J Oral Maxillofac Surg, 2012, 70(11): 2531-2542.
[20]	Rutherford DJ.Intra-articular pressures and joint mechanics: should we pay attention to effusion in knee osteoarthritis?[J]. Med Hypotheses, 2014, 83(3): 292-295.
[21]	Wu K, Huang J, Wang Q.The use of superselective arteriography in the evaluation of the influence of intracapsular hip joint pressure on the blood flow of the femoral head[J]. Med Princ Pract, 2016, 25(2): 123-129.
[22]	Wu MJ, Lu HP, Gu ZY, et al.Involvement of the MAPK pathway in the pressure-induced synovial metaplasia procedure for the temporomandibular joint[J]. Genet Mol Res, 2016, 15(2). doi: 10.4238.
[23]	Wu M, Xu T, Zhou Y, et al.Pressure and inflammatory stimulation induced increase of cadherin-11 is mediated by PI3K/Akt pathway in synovial fibroblasts from temporomandibular joint[J]. Osteoarthritis Cartilage, 2013, 21(10): 1605-1612.
[24]	Krause F, Barandun A, Klammer G, et al. Ankle joint pressure changes in high tibial and distal femoral osteotomies: a cadaver study[J]. Bone Joint J, 2017, 99-B(1): 59-65.
[25]	Choi GW, Lee SH, Nha KW, et al.Effect of combined fibular osteotomy on the pressure of the tibiotalar and talofibular joints in supramalleolar osteotomy of the ankle: a cadaveric study[J]. J Foot Ankle Surg, 2016, 56(1): 59-64.
[26]	Mcconkey MJ, Valenzano DM, Wei A, et al.Effect of the proximal abducting ulnar osteotomy on intra-articular pressure distribution and contact mechanics of congruent and incongruent canine elbows Ex vivo[J]. Vet Surg, 2016, 45(3): 347-355.

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颞下颌关节紊乱病与关节内压

Temporomandibular disorders and intra-articular pressure

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