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Temporomandibular Joint Arthroscopic Surgical Techniques: Electrocoagulation and Myotomy Indications. Atlas Oral Maxillofac Surg Clin North Am 2022; 30:165-173. [PMID: 36116875 DOI: 10.1016/j.cxom.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Temporomandibular joint (TMJ) surgical arthroscopy has become a usual operation to treat different pathologies such as internal derangements and degenerative joint diseases and osteoarthritis. Although many instruments such as palpators, forceps, scissors, scrapers, scalpels, and motorized terminals are needed to perform different arthroscopic surgical procedures, it is of paramount importance to have devices that allow the surgeon to cut and coagulate tissues safely. Coblation (cold ablation) is a process that using a radiofrequency electrical energy passing through saline solution and produces plasma that can be applied precisely to tissues to break molecular bonds within cells. This surgical technique has become the best surgical option to perform different arthroscopic surgical techniques. Coblation of synovitis areas, lysis of adhesions, disc mobilization techniques with the anterior release (capsulotomy or myotomy), and posterior coagulation of the retro discal tissues are the most common procedures performed. Disc perforations, bone chondromalacia, synovial chondromatosis (SC), and joint hypermobility can also be treated using coblation technologies.
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The Efficiency of Different Arthroscopic Discopexy Techniques Based on Clinical and Radiographic Findings: A Systematic Review. J Craniofac Surg 2022; 33:e714-e719. [PMID: 35261363 DOI: 10.1097/scs.0000000000008622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 02/18/2022] [Indexed: 10/18/2022] Open
Abstract
ABSTRACT The aim of this systematic review was to evaluate the effectiveness of different temporomandibular joint arthroscopic discopexy techniques.The systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and an electronic search was performed using MEDLINE (PubMed), The Cochrane Library, ScienceDirect databases using a combination of the terms "discopexy," "disc recapture," "disc fixation," and "temporomandibular joint" to identify clinical trials published from 2010.In total, 493 records were screened, of which only 9 fulfilled the inclusion criteria and were included in qualitative data synthesis.The results of clinical findings evaluation showed that arthroscopic discopexy statistically significantly improved levels of pain (VAS) and maximum interincisal opening whereas magnetic resonance imaging evaluation showed disc position improvement of up to 90% to 100%.In conclusion, this review provides the evidence of the potential benefits of arthroscopic disc fixation in the treatment of patients with internal derangements : reduced pain, increased maximum interincisal opening, and improved disc position evaluated by magnetic resonance imaging, whereas disc fixation using suturing techniques seems to be the most appropriate method.
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Li Y, Wang R, Wang GE, Feng S, Shi W, Cheng Y, Shi L, Fu K, Sun J. Mutually Noninterfering Flexible Pressure-Temperature Dual-Modal Sensors Based on Conductive Metal-Organic Framework for Electronic Skin. ACS NANO 2022; 16:473-484. [PMID: 34918906 DOI: 10.1021/acsnano.1c07388] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Pressure and temperature are two important indicators for human skin perception. Electronic skin (E-skin) that mimics human skin within one single flexible sensor is beneficial for detecting and differentiating pressure and temperature and showing immunity from tensile strain disruptions. However, few studies have simultaneously realized these conditions. Herein, a flexible and strain-suppressed pressure-temperature dual-modal sensor based on conductive and microstructured metal-organic framework (MOF) films was reported and mainly prepared by in situ growing Ni3(HiTP)2 onto microstructured mixed cellulose (MSMC) substrates. The sensor exhibits distinguishable and strain-suppressed properties for pressure (sensing range up to 300 kPa, sensitivity of 61.61 kPa-1, response time of 20 ms, and ultralow detection limit of 1 Pa) and temperature sensing (sensitivity of 57.1 μV/K). Theoretical calculations successfully analyzed the mutually noninterfering mechanism between pressure and temperature. Owing to its effective perception in static and dynamic surroundings, this sensor has great potential applications, such as in electronic skin and smart prosthetics.
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Affiliation(s)
- Yuxiang Li
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 1295 Ding Xi Road, Shanghai 200050, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, 19 Yuquan Road, Beijing 100049, China
| | - Ranran Wang
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 1295 Ding Xi Road, Shanghai 200050, China
- School of Chemistry and Materials Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, 1 Sub-lane Xiangshan, Hangzhou 310024, China
| | - Guan-E Wang
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, 155 Yangqiao West Road, Fuzhou 350002, China
| | - Shiyang Feng
- Central Laboratory, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Beijing 100081, China
- National Clinical Research Center for Oral Diseases, 22 Zhongguancun South Avenue, Beijing 100081, China
| | - Wenge Shi
- Central Laboratory, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Beijing 100081, China
- National Clinical Research Center for Oral Diseases, 22 Zhongguancun South Avenue, Beijing 100081, China
| | - Yin Cheng
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 1295 Ding Xi Road, Shanghai 200050, China
| | - Liangjing Shi
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 1295 Ding Xi Road, Shanghai 200050, China
| | - Kaiyuan Fu
- Central Laboratory, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Beijing 100081, China
- National Clinical Research Center for Oral Diseases, 22 Zhongguancun South Avenue, Beijing 100081, China
| | - Jing Sun
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 1295 Ding Xi Road, Shanghai 200050, China
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Effectiveness of disk repositioning and suturing comparing open-joint versus arthroscopic techniques: a systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:506-513. [PMID: 34034997 DOI: 10.1016/j.oooo.2021.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 02/03/2021] [Accepted: 02/21/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this study was to present a systematic review of the effectiveness of discopexy in managing internal derangement of the temporomandibular joint (TMJ). STUDY DESIGN We searched MEDLINE through PubMed, SCOPUS, Web of Science, and Cochrane Central Register of Controlled Trials and grey literature accessed through Google Scholar, Openthesis, and hand-searching from inception to July 2020. The search strategy yielded 363 potentially relevant studies. After screening titles and abstracts, 41 full-text articles were assessed for eligibility and 7 studies were included in the meta-analysis. RESULTS There was an overall decrease in visual analog scale (VAS) pain score of 4.59 cm (95% confidence interval [CI], 2.03-7.16; P < .001) during the follow-up time and an overall increase of 10 mm (95% CI, 6.93-13.01; P < .001) in mouth opening after TMJ surgeries with discopexy. CONCLUSIONS The available evidence showed an overall decrease in VAS pain score and an improvement in mouth opening after TMJ surgeries with discopexy. Changes in maximal interincisal opening were greater after arthroscopic disk repositioning compared to open-joint procedure.
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Fan B, Liu X, Chen X, Xu W, Zhao H, Yang C, Zhang S. Periostin Mediates Condylar Resorption via the NF-κB-ADAMTS5 Pathway. Inflammation 2021; 43:455-465. [PMID: 31840212 DOI: 10.1007/s10753-019-01129-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Although the up-regulation of periostin in osteoarthritic (OA) is found, its function on OA condyle caused by disc displacement is not clear. Our objective was to explore whether periostin has any effect on condylar resorption. We initially identified periostin-positive cells in temporomandibular joint osteoarthritic (TMJ-OA) cartilage. Furthermore, the vitro analysis confirmed that the expression of periostin in chondrocytes treated with a static pressure of 150 kpa and 200 kpa for 3 h by an in-house-designed pressure chamber. To explore the underlying mechanism, we found that periostin can induce IκBα phosphorylation and its subsequent degradation, leading to consequent p65 nuclear translocation and subsequent induction of ADAMTS5 expression, which is known to be detrimental to cartilage extracellular matrix production. Importantly, inhibiting NF-κB signaling, by BAY 11-7082 treatment, rescued periostin-induced ADAMTS5 up-regulation. This study elucidated the direct role of periostin in condylar resorption, which was found to occur via NF-κB-ADAMTS5 signaling. Inhibition of this pathway might provide a new strategy for TMJ-OA treatment.
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Affiliation(s)
- Baoting Fan
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key laboratory of Stomatology & Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center of Stomatology, Shanghai, 200011, People's Republic of China
| | - Xiaohan Liu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key laboratory of Stomatology & Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center of Stomatology, Shanghai, 200011, People's Republic of China
| | - Xinwei Chen
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key laboratory of Stomatology & Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center of Stomatology, Shanghai, 200011, People's Republic of China
| | - Weifeng Xu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key laboratory of Stomatology & Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center of Stomatology, Shanghai, 200011, People's Republic of China
| | - Huaqiang Zhao
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Department of Oral and Maxillofacial Surgery, School of Stomatology, Shandong University, Shandong, 250012, People's Republic of China
| | - Chi Yang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key laboratory of Stomatology & Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center of Stomatology, Shanghai, 200011, People's Republic of China
| | - Shanyong Zhang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key laboratory of Stomatology & Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
- National Clinical Research Center of Stomatology, Shanghai, 200011, People's Republic of China.
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Giraudeau A, Jeany M, Ehrmann E, Déjou J, Ouni I, Orthlieb JD. Disc displacement without reduction: a retrospective study of a clinical diagnostic sign. Cranio 2016; 35:86-93. [PMID: 27077248 DOI: 10.1080/08869634.2016.1149291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The purpose of this retrospective study is to evaluate a clinical diagnostic sign for disc displacement without reduction (DDWR), the absence of additional condylar translation during opening compared with protrusion. METHOD Thirty-eight electronic axiographic and magnetic resonance imaging (MRI) examinations of the TMJ were analyzed in order to compare the opening/protrusion ratio of condylar translation between non-painful DDWR and non-DDWR. RESULT According to the Mann-Whitney U test, the opening/protrusion ratio in non-painful DDWR differs significantly from non-DDWR (p < 0.0001). DISCUSSION Among non-painful DDWR, there is no additional condylar translation during opening in comparison with protrusion, and this is probably also the case for DDWR without limited opening, which is a subtype that has not been validated by the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Comparative condylar palpation can analyze this sign, and therefore, further comparative investigations between MRI and clinical examination are needed to validate the corresponding clinical test.
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Affiliation(s)
- Anne Giraudeau
- a Faculté d'Odontologie , Aix Marseille Université , Marseille 13005 , France
| | - Marion Jeany
- a Faculté d'Odontologie , Aix Marseille Université , Marseille 13005 , France
| | - Elodie Ehrmann
- b Faculté d'Odontologie , Université de Nice Sophia-Antipolis , Nice 06357 , France
| | - Jacques Déjou
- a Faculté d'Odontologie , Aix Marseille Université , Marseille 13005 , France
| | - Imed Ouni
- c Faculty of Odontology , Monastir University , Monastir 5019 , Tunisia
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Abboud WA, Givol N, Yahalom R. Arthroscopic lysis and lavage for internal derangement of the temporomandibular joint. Ann Maxillofac Surg 2016; 5:158-62. [PMID: 26981463 PMCID: PMC4772553 DOI: 10.4103/2231-0746.175754] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Arthroscopy of the temporomandibular joint (TMJ) is a valuable diagnostic and therapeutic tool for various intra-articular disorders, especially internal derangement (ID) of the TMJ. OBJECTIVES To evaluate the efficacy and safety of a standardized arthroscopic procedure for the treatment of two stages of ID; early/intermediate stage and intermediate/late stage. MATERIALS AND METHODS Retrospective analysis of medical records of 78 patients (99 joints) treated by arthroscopic lysis and lavage in the authors' department during a 5-year period. Patients were diagnosed preoperatively as suffering from ID of the TMJ. The results were stratified according to the stage of ID. Three outcome variables were used to assess efficacy of treatment: Maximal interincisal opening (MIO), level of pain on a visual analog scale (VAS), and frequency of intermittent locking episodes. In addition, complications were reported. RESULTS Mean MIO of the group of patients with intermediate/late stage ID increased from 27 ± 4.7 mm preoperatively to 38 ± 5.4 mm postoperatively (P < 0.0001). For the group of patients with early/intermediate stage ID, mean MIO did not change significantly after arthroscopy (39.1 ± 6.2 mm compared to 41.4 ± 5 mm, P = 0.06), however, subjective evaluation of pain on a VAS decreased from 7.2 ± 1.2 preoperatively to 3.4 ± 2.2 postoperatively (P < 0.0001), and 80% of the patients (25 of 31) denied experiencing intermittent locking episodes after treatment (P < 0.0001). CONCLUSION Arthroscopic lysis and lavage is a safe and effective therapeutic modality for the treatment of both mild and advanced stages of ID.
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Affiliation(s)
- Waseem A Abboud
- Department of Oral and Maxillofacial Surgery, Sheba Medical Center, Tel-Hashomer, Affiliated to Sackler School of Medicine, Tel-Aviv University, Israel
| | - Navot Givol
- Department of Oral and Maxillofacial Surgery, Sheba Medical Center, Tel-Hashomer, Affiliated to Sackler School of Medicine, Tel-Aviv University, Israel
| | - Ran Yahalom
- Department of Oral and Maxillofacial Surgery, Sheba Medical Center, Tel-Hashomer, Affiliated to Sackler School of Medicine, Tel-Aviv University, Israel
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Treatment of Intermittent Locking of the Jaw in Wilkes Stage II Derangement by Arthroscopic Lysis and Lavage. J Oral Maxillofac Surg 2015; 73:1466-72. [DOI: 10.1016/j.joms.2015.02.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 02/06/2015] [Accepted: 02/27/2015] [Indexed: 11/22/2022]
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Millon-Cruz A, Martín-Granizo R, Encinas A, Berguer A. Relationship between intra-articular adhesions and disc position in temporomandibular joints: Magnetic resonance and arthroscopic findings and clinical results. J Craniomaxillofac Surg 2015; 43:497-502. [DOI: 10.1016/j.jcms.2015.02.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 01/08/2015] [Accepted: 02/13/2015] [Indexed: 11/27/2022] Open
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McCain JP, Hossameldin RH, Srouji S, Maher A. Arthroscopic discopexy is effective in managing temporomandibular joint internal derangement in patients with Wilkes stage II and III. J Oral Maxillofac Surg 2014; 73:391-401. [PMID: 25530277 DOI: 10.1016/j.joms.2014.09.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 09/09/2014] [Accepted: 09/10/2014] [Indexed: 11/15/2022]
Abstract
PURPOSE Disc repositioning for temporomandibular joint (TMJ) internal derangement (ID) is a well-established surgical technique with variable success. The purpose of the present study was to assess the outcomes after arthroscopic disc repositioning (discopexy) for TMJ ID. PATIENTS AND METHODS This was a prospective, cohort, single-institutional clinical study. The study included patients with TMJ ID in whom diagnostic arthroscopy had failed. These patients were presented and treated at Miami Oral and Maxillofacial Surgery, Baptist Hospital (Miami FL). The predictive variable was the Wilkes diagnostic categories, presented in 2 groups: II and III versus IV and V. The primary outcome variable was the absence of joint pain at 12 months postoperatively. The secondary outcome variables included joint function, maximum interincisal opening, medication use, joint loading sign, and muscle pain. The patients were followed for 1 year postoperatively. The statistical analyses included paired and independent sample Student's t test, χ(2) test, and logistic regression analysis. RESULTS A total of 32 subjects (42 joints), with a mean age of 31 years, were included in the present study; 28 (87.5%) were women. Of the 42 joints, 71.4% were classified as Wilkes stage II and III. A successful outcome was seen in 69% of the studied subjects and in 86.7% of the Wilkes II and III group versus 25% of the Wilkes IV and V group (P = .001). CONCLUSION The results of the present study have shown that TMJ arthroscopic discopexy is an effective and predictable treatment of patients with TMJ ID in whom primary TMJ arthroscopy failed. Our results have also shown that patients with Wilkes II or III TMD will have the most successful outcome.
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Affiliation(s)
- Joseph P McCain
- Oral & Maxillofacial Surgeon, Private Practice, Oral and Maxillofacial Surgery, Miami, FL; Chief, Department of Oral and Maxillofacial Surgery, Baptist Health Systems, Jacksonville, FL; Clinical Associate Professor, Department of Oral and Maxillofacial Surgery, Florida International University Herbert Wertheim College of Medicine, Miami, FL; Adjunct Professor, Department of Oral and Maxillofacial Surgery, Nova Southeastern School of Dental Medicine, Fort Lauderdale, FL
| | - Reem H Hossameldin
- Assistant Lecturer, Department of Oral and Maxillofacial Surgery, Cairo University School of Dental Medicine, Cairo, Egypt; Research Scholar, Department of Oral and Maxillofacial Surgery, Florida International University Herbert Wertheim College of Medicine, Miami, FL.
| | - Samer Srouji
- Surgeon, Department of Oral and Maxillofacial Surgery, Carmel Medical Center, Haifa, Israel; Department of Anatomy and Cell Biology, Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Amr Maher
- Anesthesia Consultant, Cairo University School of Dental Medicine, Cairo, Egypt; Biostatistician, Cairo University, Cairo, Egypt
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Goizueta-Adame CC, Pastor-Zuazaga D, Orts Bañón JE. Arthroscopic disc fixation to the condylar head. Use of resorbable pins for internal derangement of the temporomandibular joint (stage II–IV). Preliminary report of 34 joints. J Craniomaxillofac Surg 2014; 42:340-6. [DOI: 10.1016/j.jcms.2013.05.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 05/28/2013] [Accepted: 05/28/2013] [Indexed: 10/26/2022] Open
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Weedon S, Ahmed N, Sidebottom A. Prospective assessment of outcomes following disposable arthroscopy of the temporomandibular joint. Br J Oral Maxillofac Surg 2013; 51:625-9. [DOI: 10.1016/j.bjoms.2013.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 06/10/2013] [Indexed: 11/26/2022]
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Abstract
The aim of this study was to examine the changes of the synovial tissue in rabbit temporomandibular joint (TMJ) internal derangement (ID) models using light and electron microscope. Thirteen rabbits were included in our study. The right TMJ of all animals were used as the experimental group while the left ones as the control group. ID model was established by using elastic rubber rope to stretch anteriorly. Synovial tissues were collected and examined by light and electron microscope to observe microstructure and ultrastructure changes after establishing the model. CD34 was used to count small blood vessels. A paired t test was performed with SPSS 16.0 software package to compare the data of the experimental and the control side. The average number of small blood vessels in the experimental side was significantly greater than the control side both in the first and second week. Numerous synovial cells of type A and type B were detected under electron microscope, and type A cells shrunk after a period of time. This study is helpful to understand the development of the TMJ intra-articular adhesion.
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