| Temporomandibular joint disorders(TMD) was a clinical syndrome which was characteristic of joint click, pain and dysfunction . TMD were very difficult to treat because the etiology was complex. People were looking for the pathological mechanism of TMD and effective methods of treatment all the while. Arthrocentsis and viscosupple mentation were both effective ways of treatment for TMD. But all reports on above two methods were based on clinical trial and little paper of animal experiment on this issue was introduced so far. The real treatment mechanism still remained unclear. In this paper, the experimental research was carried out to study the pathological mechanism and the effect on histo-pathological change in TMJ tissues of two treatment methods after establishing animal model of TMD. The mechanism of two methods and their indications were investigated as well, so that reference could be offered in clinical practice.This study included three parts as follows:Part I: Establishing animal model of TMD 1. Establishing animal model of TMDMaterials and methods: 0.1ml MMPs-1 was injected into the left upper cavity of the joints of 20 adult New Zealand rabbits, and normal saline was injected into the right joint for comparative study. Four rabbits were killed on 24 hours, 2, 4, 8, 12 weeks after the injection respectively. The joints were removed and observed morphologically and histologically.Results: In the left joint, acute synovitis appeared after 24 hours postoperatively. After the second week, chronic synovitis and partly-collapsed superficial zone of cartilage were found, which were both accordance with the original pathological appearance of TMJOA.After the 12th week, Perforation in joint disk and collapse in cartilage could be found. No pathological change was found in the right joint. Conclusion: The animal models of synovitis and osteoarthritis of TMJ were established successfully by intra-articular injection MMPs-1.2. The histochemistry research on TMJOAMaterials and Methods: 10 New Zealand rabbits were injected with O.lml MMPs-1 into the left joint cavity. Two rabbits were killed at 24 hours, 2, 4, 8,12weeks after the injection respectively. The joint was stained with AB-PAS and MAS SON. Changes of proteoglycans, collagen fiber and elastic fiber were observed under microscope. Results: With the AB-PAS the dye of proteoglycan in cartilage was thinned slightly after the first week. The dye of proteoglycan was not in equal after the fourth week; with MAS SON collagen fiber and elastic fiber of joint disk was arranged in disorder. The dye of proteoglycan thinned terribly; with MASSON the collagen fiber and elastic fiber were ruptured after the 12th week.Conclusion: The losing of proteoglycan was the first feature in the pathological change of TMJOA. The collapse of elastic fiber and collagen fiber advanced the development of TMJOA.Part n : The study of arthrocentesis in treatment of TMD Materials and methods: 24 adult New Zealand rabbits were randomly divided into two groups. The animal models of bilateral synovitis and osteoarthritis were established by intra-articular injection MMPs-1 respectively. Arthrocentesis was carried out in the left joint cavity. The right joint was used as a control. The change of all component of joint was investigated at the different times.Results: In synovitis group, the pathological change of left joint was obviously gentler than that of right joint. In osteoarthritis group, thepathological change of left joint was almost the same as the right one ,but it's extent was gentler slightly than in the right joint. Conclusion: Arthrocentesis had obviously effection to treat synovitis, but it could not inhibit the development of osteoarthritis.Part III: The study of viscosupple mentation in treatment of TMD Materials and methods: Bilateral osteoarthritis of 24 rabbits were established by intra-articular injection MMPs-1 and randomly divided into three groups: arthrocentesis group (A group), viscosupple mentation group (B group) and unitization... |
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