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目的:观察髁状突纵形骨折后及牙合夹板治疗时髁状突、关节盘的改变。探讨牙合夹板治疗机制。方法:实用小型猪18头,随机分为髁状突纵形骨折后未治疗组,牙合夹板治疗组及对照组各6头。实验后3、6、12周取材,光镜扫描电镜观察。结果:牙合板治疗髁状突纵形骨折12周,骨折愈合,无盘突粘连。生发层细胞和表层纤维连续,其下是新生软骨细胞和大量软骨内化骨现象。未治疗组3周关节盘轻度变形,12周关节盘与髁状突、颞下凹粘连,呈双髁突畸形。电镜下牙合夹板治疗组骨折侧髁突表面凝胶样物质尚存,细胶原纤维暴露。未治疗组骨折侧髁突表面凝胶状物质消失,有的部位胶原纤维粗大,有的部位细小。结论:髁状突纵形骨折未治疗后果为盘突粘连,双髁突畸形。牙合夹板具有防止盘突粘连,使髁状突恢复正常生长发育的作用。
Objective: To observe the changes of condyles and articular disc after condylar longitudinal fracture and occlusal splints. To explore the mechanism of occlusion splint. Methods: A total of 18 miniature pigs were randomly divided into untreated condylar fractures, occlusal splints and control group. 3,6,12 weeks after the experiment drawn, light microscopy scanning electron microscopy. Results: The patella plate was treated for longitudinal condylar fractures for 12 weeks, with fracture healing and diskless process. The germinal layer cells and superficial fibers are continuous, underneath are nascent cartilage cells and a large amount of cartilage internalization. In the untreated group, the disc degeneration was mild at 3 weeks, and the disc at 12 weeks was associated with condyle and temporomandibular indentation. Electron microscope occlusal splint treatment group fracture side condyle surface gel-like substances remain, fine collagen fibers exposed. In the untreated group, the surface of the condylar surface gel-like substance disappeared, some parts of the collagen fibers thick, and some small parts. Conclusion: The unprocessed condylar longitudinal fracture is disc herniation and double condyle deformity. Occlusal splint with disc to prevent adhesion, the condyle to restore normal growth and development.