Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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ANALYSIS OF TMJ STATUS IN THE PATIENTS WITH MANDIBULAR FRACTURES: PRELIMINARY STUDY ARTHROSCOPIC EXAMINATION, HISTOMORPHOLOGY AND JOINT FLUID ANALYSIS

하악골 골절 환자들의 악관절 상태 평가: 일차보고 관절내시경적 검사, 조직형태학적 및 관절활액 분석

  • Kim, Young-Kyun (Dept. of Oral & Maxillofacial Surgery, Pundang Jesaeng Hospital, DMC) ;
  • Kim, Hyoun-Tae (Dept. of Oral & Maxillofacial Surgery, Pundang Jesaeng Hospital, DMC) ;
  • Lee, Do-Hoon (Dept. of Clinical Pathology, Pundang Jesaeng Hospital, DMC) ;
  • Choi, Yoon-Jung (Dept. of Diagnostic Pathology, Pundang Jesaeng Hospital, DMC) ;
  • Chung, Hoon (Korean TMJ Research Institute)
  • 김영균 (대진의료재단 분당제생병원 구강악안면외과) ;
  • 김현태 (대진의료재단 분당제생병원 구강악안면외과) ;
  • 이도훈 (대진의료재단 분당제생병원 임상병리과) ;
  • 최윤정 (대진의료재단 분당제생병원 진단병리과) ;
  • 정훈 (대한악관절 연구소)
  • Published : 2001.08.31
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Abstract

The purpose of this study is to validate the potential etiologic factors for temporomandibular disorder(TMD). TMJ arthroscopic examination was performed in upper joint compartment of 32 joints from 20 patients with mandibular fractures. Synovial fluid was collected from the upper joint space during pumping manipulation with normal saline. Cytologic smearing and histomorphologic exam of synovial fluid were performed in 15 joints. Prostaglandin $E_2(PGE_2)$ concentration was measured in 11 joints. Leukotriene $B_4(LTB_4)$ concentration was measured in 8 joints. There were several arthroscopic variables such as ecchymosis, fibrillation, and adhesion. Histomorphologic exam showed a variety of findings such as bloody smears, cellular cluster, degenerated cells and cartilage, undifferentiated crystal. Mean $PGE_2$ concentrations were 316.5 pg/ml. Mean LTB4 concentrations were 45.9pg/ml. This study demonstrated a variety of findings on inflammatory and degenerative changes of TMJ. Because acute trauma such as mandibular fracture is a major etiologic factor in cartilage degradation and biochemical and intraarticular pathology, clinicians must identify and address TMJ signs and symptoms during follow-up periods in the long term.

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