Mandibular Condyle

下颌髁突
  • 文章类型: Journal Article
    背景:TMJ形态/位置和小梁结构受各种因素的影响。切角的作用,前牙咬合关系的指标,TMJ仍不清楚。本研究旨在调查形态学,骨小梁结构,和髁的位置,以及不同切间角的II类骨骼人群的关节盂窝形态。
    方法:选择150例正常面部类型和骨骼II类错牙合的成年患者,并根据其切间角度分为三组:正常,小,和大角度组。使用锥形束计算机断层扫描(CBCT)数据测量TMJ的指标,并使用海豚成像进行分析。模仿,ImageJ
    结果:小角度组前后径(APD)最小,而大角度组的中外侧直径(MLD)更大。大角度组表现出显著的最大轴向面积,骨表面积,骨体积(P<0.05)。小角度组和大角度组表现出较大的骨小梁(Tb。N)和较薄的小梁厚度(Tb。Th).与正常角度组相比,小角组在轴面上表现出较大的水平髁角和较小的双侧髁角,而大角度组表现出相反的趋势。小角度组和大角度组显示冠状平面上的垂直髁角度减小,在大角度组观察到最大的减少(P<0.05)。小角度组和大角度组的关节盂窝(GFH)高度较高。大角度组表现出最大的GFH和关节盂窝宽度(GFW)(P<0.05)。
    结论:大角度组有细长的椭圆形和大髁,和更深的关节盂窝,而扁平的椭圆形和较小的髁,小角度组关节盂窝较宽,较浅。小和大的切间角影响髁突小梁的结构,导致更薄的Tb。Th和更大的Th.N.在髁突位置,小角度和大角度组在轴向和冠状平面上表现出con突旋转。因此,切向角影响形态,position,和TMJ的小梁结构。这意味着我们必须注意切向角对TMJ的影响,在正畸治疗过程中,恢复正常的切角至关重要。
    BACKGROUND: TMJ morphology/position and trabecular structure are influenced by various factors. The role of the interincisal angle, an indicator of the anterior occlusal relationship, on TMJ remains unclear. This study aims to investigate the morphology, trabecular bone structure, and position of the condyle, as well as the glenoid fossa\'s morphology in skeletal class II populations with different interincisal angles.
    METHODS: A total of 150 adult patients with normodivergent facial types and skeletal class II malocclusions were selected and divided into three groups based on their interincisal angles: normal, small, and large angle groups. The indexes of TMJ were measured using cone-beam computed tomography (CBCT) data and analyzed using Dolphin Imaging, Mimics, and ImageJ.
    RESULTS: The small angle group had the smallest anteroposterior diameter (APD), while the large angle group had a greater mediolateral diameter (MLD). The large angle group exhibited significantly the largest maximum axial area, bone surface area, and bone volume (P < 0.05). Small and large angle groups exhibited greater bone trabeculae (Tb. N) and thinner trabecular thickness (Tb. Th). Compared to the normal angle group, the small angle group exhibited a larger horizontal condylar angle and smaller bilateral condylar angles on the axial plane, while the large angle group showed the opposite trend. Small and large angle groups showed a reduced vertical condyle angle on the coronal plane, with the largest reduction observed in the large angle group (P < 0.05). Small and large angle groups had higher heights of the glenoid fossa (GFH). The large angle group exhibited the greatest GFH and width of the glenoid fossa (GFW) (P < 0.05).
    CONCLUSIONS: The large angle group had elongated oval and large condyles, and deeper glenoid fossae, while a flattened-oval and smaller condyle, and wider and shallower glenoid fossae were observed in the small angle group. Small and large interincisal angle affects the structure of condylar trabeculae, resulting in thinner Tb. Th and greater Th. N. In the condylar position, small and large angle groups exhibit condylar rotation in the axial and coronal planes. Therefore, the interincisal angle affects the morphology, position, and trabecular structure of the TMJ. This implies that we must pay attention to the impact of the interincisal angle on TMJ, and it is crucial to restore the normal interincisal angle during orthodontic treatment.
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  • 文章类型: Journal Article
    背景:出现部分受累的下第三磨牙(M3)的患者发生角骨折的可能性更高,同时降低了髁突骨折的风险。然而,导致这种情况发生的具体生物力学机制尚不清楚。此外,关于去除M3是否真的会增加髁突骨折的风险,目前仍在争论.这项研究旨在评估M3s的存在如何影响由于对联合骨和下颌骨外侧体的打击而导致的下颌骨骨折。并确定在这种情况下提取M3s的指示。
    方法:具有部分M3冲击模型(M3I)的下颌骨模型,M3提取模型(M3E),使用计算机生成M3缺失模型(M3A)。对下颌骨的联合和右体施加了2000N的外伤吹制力。VonMises和主应力进行了分析,并确定了失效指标。选择2例下颌骨线性骨折进行模型验证和解释。
    结果:当力施加到联合处,髁区表现出最高的应力水平,而无论M3状态如何,下颌角区域的应力都要小得多。在向右下颌骨施加力时,髁突区域的应力下降,而下颌体的应力增加,尤其是在被吹的地区。M3拔除后的撞击牙齿或空腔形成导致下颌骨吹制侧的应力分布不均匀,增加下颌角骨折的风险。在M3缺失或拔牙槽愈合的情况下,来自侧向创伤吹力的应力沿下颌骨的内斜线和外斜线均匀分布,从而降低下颌骨骨折的风险。
    结论:下M3s和下颌角骨折的患者发生髁突骨折的风险降低主要是由于对下颌骨的侧向打击,在髁突区域产生的应力比在下颌联合处产生的应力小,而不是由M3本身造成的。拔除下M3可以降低下颌骨骨折的风险,对髁突骨折影响较小.
    BACKGROUND: Patients presenting with partially impacted lower third molars (M3) have a higher likelihood of experiencing angle fractures while simultaneously decreasing the risk of condylar fractures. However, the specific biomechanical mechanism responsible for this occurrence remains unclear. Moreover, there is an ongoing debate regarding whether the removal of M3s might actually increase the risk of condylar fractures. This study aimed to evaluate how the presence of M3s influences mandibular fractures resulting from blows to the symphysis and lateral mandibular body, and to determine the indication for extracting M3s in such cases.
    METHODS: Models of the mandible with a partially M3-impacted model (M3I), M3-extracted model (M3E), and M3-absent model (M3A) were generated using a computer. A traumatic blown force of 2000 N was applied to the symphysis and the right body of the mandible. Von Mises and principal stresses were analyzed, and failure indexes were determined. Two cases of mandibular linear fractures were chosen for model verification and interpretation.
    RESULTS: When force was applied to the symphysis, the condylar region exhibited the highest stress levels, while stress in the mandibular angle region was much less regardless of the M3 state. On applying the force to the right mandibular body, stress in the condylar region decreased while stress in the mandibular body increased, especially in the blown regions. Impacted tooth or cavity formation post-M3 extraction led to uneven stress distribution on the blown side of the mandible, increasing the risk of mandibular angle fractures. In cases where M3 was absent or the extraction socket had healed, stress from lateral traumatic blown force was evenly distributed along both the inner and outer oblique lines of the mandible, thereby reducing the risk of mandibular fractures.
    CONCLUSIONS: The reduced risk of condylar fractures in patients with partially impacted lower M3s and mandibular angle fractures is mainly due to lateral blows on the mandible, which generate less stress in the condylar region than blows on the mandibular symphysis, rather than being caused by the M3 itself. Extraction of the lower M3 can decrease the risk of mandibular fractures, with a minor influence on condylar fractures.
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  • 文章类型: Journal Article
    探讨淀粉样β肽(Aβ)对下颌髁突的影响,为绝经后女性颞下颌关节骨关节炎的治疗提供新的方法。
    通过卵巢切除术建立小鼠骨丢失模型。腹膜内注射Aβ前后,通过显微计算机断层扫描测量髁突的微观结构参数。流式细胞术,茜素红染色,RT-qPCR分析,FITC/PI染色,采用油红O染色和蛋白质印迹法评价Aβ对小鼠骨髓基质干细胞(mBMSCs)成骨分化的影响。
    体内,髁突微结构参数增加。注射Aβ后,血清骨保护素和1型前胶原N前肽呈剂量依赖性增加,这与I型胶原蛋白的c末端端肽的变化相反,肿瘤坏死因子-α和血清瘦素水平升高。体外,Aβ促进细胞内钙结节的形成。ALP的表达,Runx2、骨膜和骨钙蛋白显著增加。与Wnt信号通路相关的mRNA表达显著上调,可以被DKK1阻止。
    Aβ可通过Wnt途径促进mBMSCs的成骨分化,逆转去卵巢小鼠下颌髁突的骨丢失。
    UNASSIGNED: To explore the effect of amyloid-β peptide (Aβ) on mandibular condyle to develop a new treatment for postmenopausal women with Temporomandibular joint osteoarthritis.
    UNASSIGNED: A murine bone loss model was established by ovariectomy. Microstructure parameters of the condyle were measured by microcomputed tomography before and after intraperitoneal injection with Aβ. Flow cytometry, Alizarin red staining, RT-qPCR assays, FITC/PI staining, Oil Red O staining and western blotting were used to evaluate the effect of Aβ on the osteogenic differentiation of mouse bone marrow stromal stem cells (mBMSCs).
    UNASSIGNED: In vivo, condylar microstructure parameters increased. Serum osteoprotegerin and procollagen type 1 N propeptide increased in a dose-dependent manner after the injection of Aβ, which were opposite the changes observed in c-terminal telopeptides of type I collagen, tumor necrosis factor-α and the high serum level of leptin. In vitro, Aβ promoted calcium nodule formation in the cells. The expression of ALP, Runx2, osteorix and osteocalcin increased significantly. The expression of mRNAs related to the Wnt signaling pathway was significantly upregulated, which could be blocked by DKK1.
    UNASSIGNED: Aβ can reverse bone loss in the mandibular condyle in ovariectomized mice through promoting the osteogenic differentiation of mBMSCs via the Wnt pathway.
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  • DOI:
    文章类型: English Abstract
    目的:探讨颌面部骨软骨瘤的临床和病理特点,总结少见骨软骨瘤恶变的临床病理特点,以期为临床提供指导。
    方法:回顾性收集2018年1月至2023年9月上海市第九人民医院骨软骨瘤患者171例,上海交通大学医学院。分析其术前CT及临床病理特征。
    结果:在171例颌面部骨软骨瘤患者中,66%(113/171)为女性,34%为男性。他们的年龄为11-76岁,平均年龄为44岁。在171个案例中,95.3%(163/171)位于下颌骨髁突,下颌骨冠状突4%(7/171),和0.5%(1/171)的颧弓。影像学检查显示,98%(159/161)的髁突病变患者软骨帽厚度小于1cm。仅2例(2/171,1.1%)发生恶变。一个被诊断为继发性软骨肉瘤,另一个发展为低级骨肉瘤。
    结论:颌面部骨软骨瘤多发生于女性,最常见于髁突,恶性变化率为1.1%,这与身体的其他部位相似。影像学表现对骨软骨瘤恶变的诊断具有重要的指导意义。
    OBJECTIVE: To investigate the clinical and pathological features of osteochondroma in maxillofacial region, and to summarize the clinicopathological features of rare osteochondroma malignant transformation in order to provide clinical guidance.
    METHODS: From January 2018 to September 2023, a total of 171 patients with osteochondroma were retrospectively collected in Shanghai Ninth People\'s Hospital, Shanghai Jiao Tong University School of Medicine. Their preoperative CT and clinicopathological features were analyzed.
    RESULTS: Of the 171 patients with osteochondroma in maxillofacial bone, 66%(113/171) were females and 34% were male. Their age ranged from 11-76 with an average age was 44 years old. Of the 171 cases, 95.3%(163/171)in mandible condyle, 4%(7/171) in mandible processus coronoideus, and 0.5%(1/171) in zygomatic arch. The imaging findings showed that the thickness of cartilaginous cap was less than 1 cm in 98%(159/161) cases with condyle lesions. Only 2 cases(2/171, 1.1%) had malignant transformation. One was diagnosed with secondary chondrosarcoma, another developed low-grade osteosarcoma.
    CONCLUSIONS: Osteochondroma in maxillofacial region mostly occurs in females, and most commonly located in condylar process, with a malignant change rate of 1.1%, which is similar to that of other parts of the body. Imaging findings have important guiding significance for the diagnosis of osteochondroma malignant change.
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  • DOI:
    文章类型: English Abstract
    目的:探讨成人和青少年下颌偏位患者的咬合与双侧颞下颌关节(TMJ)间隙的相关性,并研究咬合与下颌位置的相互影响。以期为临床治疗提供参考。
    方法:选择下颌偏曲患者(成人20例,青少年20例)的CBCT资料。Inivo5牙科解剖软件用于重建结构。测量了从犬齿到第一磨牙的双侧上颌的咬合斜度和垂直高度,并计算了两侧相同牙齿之间的垂直高度差。前部,两组分别测量颞下颌关节上间隙和后间隙。采用SPSS17.0软件包对咬合倾斜与双侧髁空间进行Pearson相关性分析。
    结果:在少年组中,偏侧咬合斜度与颞下颌关节上间隙呈负相关(P<0.05)。幼组犬的垂直高度差与偏侧TMJ前间隙呈负相关(P<0.05).在成人组中,相关检查间无明显相关性(P>0.05)。
    结论:下颌偏位患者早期咬合与下颌位置呈中度相关。下颌偏斜的早期治疗对于防止其发展为严重的骨骼错牙合非常重要。额叶倾斜遮挡平面的矫正应给予更多的关注。
    OBJECTIVE: To investigate the correlation between the occlusal canting and the bilateral temporomandibular joint (TMJ) space in adult and juvenile mandibular deviation patients and study the mutual influence between the occlusal canting and mandibular position, in order to provide references for clinical treatment.
    METHODS: CBCT data of mandibular deviation patients(20 adults,20 juveniles)were selected. Inivo5 Dental Anatomage software was used to reconstruct the structures. The occlusal cant and vertical height of the bilateral maxillary from canines to first molars were measured, and the vertical heights difference between the same teeth on both sides was calculated. The anterior, superior and posterior space of temporomandibular joint were measured respectively in both groups. Pearson correlation analysis between the occlusal canting and bilateral condylar space was carried out by using SPSS 17.0 software package.
    RESULTS: In the juvenile group, negative correlations were found between the occlusal cant and the superior TMJ space on the deviated side (P<0.05). Negative correlation was found between the vertical height difference of bilateral canines and the anterior TMJ space on the deviated side in the juvenile group(P<0.05). In the adult group, no significant correlation was observed among those correlated examination (P>0.05).
    CONCLUSIONS: The occlusal canting is moderately correlated with mandibular position in the early stage of mandibular deviation patients. Early treatment of mandibular deviation is of great importance in preventing its progression into severe skeletal malocclusion, and more attention should be paid on the correction of the canted frontal occlusion plane.
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  • 文章类型: Journal Article
    目的:本研究旨在确定慢性间歇性缺氧(CIH)和应激变化(SC)对口呼吸大鼠髁突发育的影响。
    方法:将120只4周龄大鼠随机分为5组。对照组(Ctrl)为空白对照,间歇性鼻塞(INO)组为阳性对照。通过调节环境氧浓度和实时监测血氧饱和度(SpO2),建立MildCIH(mCIH)和严重CIH(sCIH)组。SC组是使用INO开发的,环境氧浓度增加,和实时SpO2监测。在0、1、2或4周处死每组6只大鼠用于分析。
    结果:与INO组类似,sCIH组的髁和下颌体发育,但不是在MCIH组,与Ctrl组相比显著抑制。SC组对髁突的发育有抑制作用,尤其是后区,但对下颌骨的生长影响很小。
    结论:CIH对髁突和下颌体发育的抑制作用是SpO2剂量依赖性的。当SC发生时,在髁后部观察到发育受到抑制,而不是整个下颌骨。这些发现为解决儿童口腔呼吸后果的针对性干预措施提供了重要见解。
    OBJECTIVE: This study aimed to determine the effects of chronic intermittent hypoxia (CIH) and stress change (SC) on the development of the condyle in mouth breathing rats.
    METHODS: A total of 120 4-week-old rats were randomly assigned to one of five groups. The control (Ctrl) group was the blank control and the intermittent nasal obstruction (INO) group was the positive control. Mild CIH (mCIH) and severe CIH (sCIH) groups were developed by adjusting environmental oxygen concentration and monitoring real-time blood oxygen saturation (SpO2). The SC group was developed using INO, increased environmental oxygen concentration, and real-time SpO2 monitoring. Six rats from each group were sacrificed for analysis at 0, 1, 2, or 4 weeks.
    RESULTS: Similar to the INO group, condyle and mandibular body development in the sCIH group, but not in the mCIH group, was significantly inhibited compared with the Ctrl group. The SC group had inhibited development of the condyle, especially of the posterior zone, but had minimal impact on the growth of the mandible.
    CONCLUSIONS: The inhibitory effects of CIH on the development of the condyle and mandibular body were SpO2-dose-dependent. When SC occurred, inhibited development was observed in the posterior zone of condyle but not the whole mandible. These findings provide important insights for targeted interventions that address the consequences of mouth breathing in children.
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  • 文章类型: Journal Article
    软骨维持关节的结构和功能,导致潜在骨关节炎的紊乱。N6-甲基腺苷(m6A),真核生物中最广泛的转录后修饰,在调节生物过程中起着至关重要的作用。虽然目前的研究表明m6A影响骨关节炎的进展,其在关节软骨发育和稳态中的功能尚不清楚。在这里,我们报道软骨细胞中的Mettl3缺乏导致下颌髁突软骨形态改变,早期颞下颌关节骨关节炎,对异常机械刺激的适应性反应减弱。机械上,METTL3调节Lats1mRNA甲基化并促进其m6A-YTHDF2依赖性方式的降解,随后影响YAP1的降解和核易位。用Hippo通路抑制剂XMU-MP-1干预减轻Mettl3敲除引起的髁突异常。我们的发现证明了METTL3在软骨发育和体内平衡中的作用,提供对骨关节炎潜在治疗策略的见解。
    Cartilage maintains the structure and function of joints, with disturbances leading to potential osteoarthritis. N6-methyladenosine (m6A), the most widespread post-transcriptional modification in eukaryotes, plays a crucial role in regulating biological processes. While current research has indicated that m6A affects the progression of osteoarthritis, its function in the development and homeostasis of articular cartilage remains unclear. Here we report that Mettl3 deficiency in chondrocytes leads to mandibular condylar cartilage morphological alterations, early temporomandibular joint osteoarthritis, and diminished adaptive response to abnormal mechanical stimuli. Mechanistically, METTL3 modulates Lats1 mRNA methylation and facilitates its degradation in an m6A-YTHDF2-dependent manner, which subsequently influences the degradation and nuclear translocation of YAP1. Intervention with the Hippo pathway inhibitor XMU-MP-1 alleviates condylar abnormality caused by Mettl3 knockout. Our findings demonstrate the role of METTL3 in cartilage development and homeostasis, offering insights into potential treatment strategies for osteoarthritis.
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  • 文章类型: Journal Article
    背景:颞下颌关节骨关节炎(TMJOA)发病率高,但其发病机制尚不清楚。昼夜节律是人体的重要振荡,影响各种生物活动。然而,目前尚不清楚昼夜节律是否影响TMJOA的发生和发展。
    方法:我们打乱了大鼠的正常节律,并检测了核心时钟基因在颌骨髁突软骨中的表达和髁突的组织学变化。分离大鼠下颌髁突软骨细胞后,我们上调或下调时钟基因Per1,检测软骨基质降解酶的表达,测试了GSK3β/β-CATENIN途径的激活,并使用激动剂和抑制剂进行了验证。最后,下调大鼠下颌髁突软骨Per1表达后,我们检查了软骨基质降解酶的表达和髁突的组织学变化。
    结果:时差导致大鼠下颌髁突TMJOA样病变,时钟基因Per1和软骨基质降解酶在大鼠髁突软骨中的表达增加。当Per1在下颌髁突软骨细胞中下调或上调时,GSK3β/β-CATENIN通路被抑制或激活,软骨基质降解酶的表达减少或增加,可以通过GSK3β/β-CATENIN途径的激活剂和抑制剂来挽救。此外,体内下颌髁突软骨中Per1下调后,显著缓解软骨退化,软骨损失,时差引起的软骨下骨丢失,并观察到GSK3β/β-CATENIN信号通路的抑制。昼夜节律中断可导致TMJOA。时钟基因Per1可通过激活GSK3β/β-CATENIN通路并促进软骨基质降解酶的表达来促进TMJOA的发生。时钟基因Per1是TMJOA防治的靶点。
    BACKGROUND: Temporomandibular joint osteoarthritis (TMJOA) has a high incidence rate, but its pathogenesis remains unclear. Circadian rhythm is an important oscillation in the human body and influences various biological activities. However, it is still unclear whether circadian rhythm affects the onset and development of TMJOA.
    METHODS: We disrupted the normal rhythm of rats and examined the expression of core clock genes in the mandibular condylar cartilage of the jaw and histological changes in condyles. After isolating rat mandibular condylar chondrocytes, we upregulated or downregulated the clock gene Per1, examined the expression of cartilage matrix-degrading enzymes, tested the activation of the GSK3β/β-CATENIN pathway and verified it using agonists and inhibitors. Finally, after downregulating the expression of Per1 in the mandibular condylar cartilage of rats with jet lag, we examined the expression of cartilage matrix-degrading enzymes and histological changes in condyles.
    RESULTS: Jet lag led to TMJOA-like lesions in the rat mandibular condyles, and the expression of the clock gene Per1 and cartilage matrix-degrading enzymes increased in the condylar cartilage of rats. When Per1 was downregulated or upregulated in mandibular condylar chondrocytes, the GSK3β/β-CATENIN pathway was inhibited or activated, and the expression of cartilage matrix-degrading enzymes decreased or increased, which can be rescued by activator and inhibitor of the GSK3β/β-CATENIN pathway. Moreover, after down-regulation of Per1 in mandibular condylar cartilage in vivo, significant alleviation of cartilage degradation, cartilage loss, subchondral bone loss induced by jet lag, and inhibition of the GSK3β/β-CATENIN signaling pathway were observed. Circadian rhythm disruption can lead to TMJOA. The clock gene Per1 can promote the occurrence of TMJOA by activating the GSK3β/β-CATENIN pathway and promoting the expression of cartilage matrix-degrading enzymes. The clock gene Per1 is a target for the prevention and treatment of TMJOA.
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    文章类型: English Abstract
    目的:研究氟中毒小鼠髁突软骨的损伤及LC3和p62的表达。
    方法:将30只4周龄雄性C57BL/6小鼠随机分为对照组和实验组,每组15只。对照组给予常规饮水,实验组给予氟浓度75mg/L的饮水,连续8周。通过改良的藏红碱O-fast绿色FCF软骨染色试剂盒观察髁突软骨的结构。免疫组化法检测MMP-13、Ⅱ型胶原、LC3和p62的表达。采用SPSS22.0软件包对免疫组化半定量结果进行双向方差分析。
    结果:与对照组相比,实验组的纤维软骨层变薄,软骨细胞较小,染色变得更深。免疫组化结果显示,实验组MMP-13和LC3的表达升高,Ⅱ型胶原和p62的表达降低。
    结论:饮用水含有75mg/L氟化物,小鼠髁突软骨变性和自噬。
    OBJECTIVE: To study the damage and the expression of LC3 and p62 of condylar cartilage in fluorosis mouse.
    METHODS: Thirty 4-week-old male C57BL/6 mice were randomly divided into control group and the experimental group with 15 animals in each group. The control group received regular drinking water and the experimental group received a fluoride concentration of 75 mg/L drinking water for 8 weeks. The structure of condylar cartilage was observed through modified safranine O-fast green FCF cartilage stain kit. Immunohistochemistry was used to detect the expression of MMP-13, type Ⅱ collagen and LC3 and p62. Two-way analysis of variance test was conducted for analysis of semi-quantitative results of immunohistochemistry using SPSS 22.0 software package.
    RESULTS: Compared with the control group, the fibrocartilage layer of the experimental group became thinner, the condrocytes were smaller, and the staining became deeper.Immunohistochemistry results showed that the expression of MMP-13 and LC3 increased; the expression of type Ⅱ collagen and p62 decreased in the experimental group.
    CONCLUSIONS: There was degeneration of the condylar cartilage and autophagy in mice with drinking water containing 75 mg/L fluoride.
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  • 文章类型: Case Reports
    据报道,一名18岁的女士在活动期接受了正确的组合型髁突增生(CH)治疗。下巴严重向左偏离,右角定在较低的水平。口头,较低的中心线向左移动,其规模达到一个下切牙的宽度。右磨牙关系是中等的。右上颌第二磨牙过度萌出,不接触下牙。由于吐舌头的习惯,手术前(T1)有2.5毫米的前开放咬伤(AOB)。在判断了所有治疗方法的利弊之后,决定进行右髁切除术和术后正畸.在正畸治疗之前(T2),当下巴居中定位时,发生了不对称的开口咬伤,由右上颌和下颌第二磨牙之间的预接触引起的。同时,T2的AOB变成了11.5毫米。与正畸相关的治疗包括四个前磨牙拔除和使用四个小艇侵入双侧上颌磨牙。最后,这种治疗实现了临床居中的下巴与两个角在同一水平。髁切除术后,大型AOB被解决了,以及双侧中性磨牙关系和门牙中线的对齐。此外,切除的右髁被连续的皮质骨覆盖,并回到关节盂窝。总之,一个极具挑战性的组合型CH病例在面部和咬合对称性方面取得了令人印象深刻的改善,多亏了髁突切除术和手术后微型工作人员辅助的正畸。
    A satisfactory treatment of an 18-year-old lady was reported with right combination-type condylar hyperplasia (CH) in active phase. The chin severely deviated to the left, with the right gonial angle locating at a lower level. Intraorally, the lower centre line shifted to the left, the scale of which reached the width of one lower incisor. The right molar relation was mesial. Right maxillary second molar over-erupted without contact to lower teeth. There had been 2.5-mm anterior open bite (AOB) before surgery (T1) due to the tongue-spitting habit. After judging the benefits and disadvantages of all treatment alternatives, the decision was made to perform a right condylectomy and post-surgery orthodontics. Before orthodontics (T2) when the chin was positioned centred, an asymmetrical open bite occurred, caused by pre-contact between the right maxillary and mandibular second molars. Meanwhile, the AOB at T2 became 11.5mm. Orthodontic-related treatment included four premolars extraction and intrusion of bilateral maxillary molars using four miniscrews. Finally, this treatment achieved a clinically centred chin with two gonial angles at the same level. Post-condylectomy, the large AOB was resolved, together with a bilateral neutral molar relationship and alignment of the incisor midlines. Besides, the resected right condyle was covered by a continuous cortex bone and returned to the glenoid fossa. In sum, a high-challenging combined-type CH case was accomplished with impressive improvement in facial and occlusal symmetry, thanks to condylectomy and post-surgery miniscrew-assisted orthodontics.
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