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目的:通过建立山羊全颞下颌关节置换模型,探讨植入后山羊的血液学和组织学变化,评价自行设计的人工全颞下颌关节假体的安全性。方法:取健康6个月龄山羊10只,随机选取6只山羊,根据其颞下颌关节螺旋CT所测参数,采用Surgicase5.0软件重建三维头颅模型,制备人工全颞下颌关节假体,选用超高分子量聚乙烯制备关节窝衬里,钛合金制作下颌固位柄及关节窝上方钛板,钴-铬-钼合金制备髁突。另4只作为正常对照组。手术切除实验组6只山羊右侧髁突及关节盘,进行全关节置换。术前1周及术后1周、1、3、6个月采血,测定肝、肾功指标。术后3、6个月取山羊的肝、肾组织和假体周围及对侧下颌骨组织,通过TUNEL染色检测凋亡细胞并进行组织病理染色。采用SPSS16.0软件包对数据进行成组t检验。结果:所有实验动物均存活至实验完成,能够正常进食。各时间点实验组与对照组肝、肾功指标差异无显著性,肝、肾组织病理染色以及凋亡率与正常对照组一致,实验侧与对照侧骨组织均无明显炎症反应,实验侧组织在术后3个月成骨细胞较对照侧增多,术后6个月与对照侧组织无显著差异。结论:自行研制的全颞下颌关节假体具有较好的生物相容性和生物安全性。
OBJECTIVE: To establish a full-temporomandibular joint replacement model of goat to investigate the hematological and histological changes of the goat after implantation and to evaluate the safety of self-designed artificial total temporomandibular joint prosthesis. Methods: Ten healthy 6-month-old goats were randomly selected. Six goats were randomly selected. According to the measured parameters of temporomandibular joint spiral CT, the three-dimensional craniofacial model was reconstructed by Surgicase 5.0 software to prepare artificial total temporomandibular joint prosthesis. The high molecular weight polyethylene was used to prepare the joint lining, the titanium alloy was used to make the mandibular retentive handle and the titanium plate above the joint. The condyle was prepared from cobalt-chromium-molybdenum alloy. The other 4 as a normal control group. Surgical removal of the experimental group of 6 goats on the right condylar and disc, for total joint replacement. One week before operation and one week after operation, blood samples were collected at 1, 3, and 6 months after operation. The indexes of liver and kidney were measured. At 3 and 6 months after operation, the goat liver and kidney tissues, the periprosthetic and contralateral mandibular tissues were taken and apoptotic cells were detected by TUNEL staining and histopathological staining. Data were grouped t-test using SPSS16.0 software package. Results: All experimental animals survived the experiment and were able to eat normally. There was no significant difference in the indexes of liver and kidney function between the experimental group and the control group at each time point. The histopathological staining and apoptosis rate of the liver and kidney were consistent with those of the normal control group. There was no obvious inflammatory reaction in the experimental and control sides, At 3 months after operation, the number of osteoblasts increased compared with the control group, but there was no significant difference between the control group and the control group at 6 months after operation. Conclusion: The self-developed total temporomandibular joint prosthesis has good biocompatibility and biosafety.