颞下颌关节病:具有组织病理学特征的回顾性研究

Tamires-Aparecida S. Rennó, A. Chung, H. Gitt, L. Corrêa, J. Luz
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引用次数: 7

摘要

目的:调查一所大学中心诊断的颞下颌关节病变的发病率,并描述其组织病理学特征。材料与方法选择某口腔颌面外科病理科室颞下颌关节病变的相应切片病例。单纯关节椎间盘疾病的病例不包括在内。结果平均年龄31.3岁,以女性居多(69.7%)。其中53.6%为单侧髁突增生,17.8%为骨性强直,14.3%为退行性关节疾病,10.7%为骨软骨瘤,3.6%为滑膜软骨瘤病。髁突增生表现为厚纤维软骨和松质骨中的软骨巢。骨性强直表现为板层骨和软骨细胞巢。退行性关节疾病表现为不规则的纤维软骨层,伴有软骨细胞聚集和软骨钙化。髁突骨软骨瘤表现为透明软骨和新骨形成区域。滑膜软骨瘤病表现为未成熟软骨组织和随机排列的软骨细胞。结论这些关节病的病理改变主要包括单侧髁突增生、肿瘤型或假瘤型骨软骨瘤和滑膜软骨瘤病、修复型骨僵硬伴骨痂形成,以及少见的退行性改变,因此得名。关键词:颞下颌关节,病理,强直,病理,关节炎,退行性,骨软骨瘤,软骨瘤病,滑膜。
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Temporomandibular arthropathies: A retrospective study with histopathological characteristics
Background To investigate the incidence of temporomandibular arthropathies diagnosed in a university center and to describe their histopathological characteristics. Material and Methods Temporomandibular arthropathy cases with corresponding slides were selected from an oral and maxillofacial surgical pathology service. Cases of exclusively articular disc disease were not included. Results The mean age was 31.3 years with a predominance of females (69.7%). Of these diagnoses, 53.6% were unilateral condylar hyperplasia, 17.8% were bony ankylosis, 14.3% were degenerative joint disease, 10.7% were osteochondroma, and 3.6% were synovial chondromatosis. Condylar hyperplasia presented as thick fibrocartilage and cartilage nests in the cancellous bone. Bony ankylosis exhibited lamellar bone and nests of chondrocytes. Degenerative joint disease presented as an irregular layer of fibrocartilage with areas of clustered chondrocytes and calcified cartilage. Osteochondroma of the condyle exhibited hyaline cartilage and areas of new bone formation. Synovial chondromatosis presented as immature cartilaginous tissue and randomly arranged chondrocytes. Conclusions The pathological alterations verified in these arthropathies involved diseases that were predominantly proliferative, i.e., unilateral condylar hyperplasia, osteochondroma and synovial chondromatosis of the tumor or pseudotumor type and bony ankylosis associated with callus formation of the reparative type, and less frequent degenerative changes for which the disease is so named. Key words:Temporomandibular joint, pathology, ankylosis, pathology, arthritis, degenerative, osteochondroma, chondromatosis, synovial.
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