下颌髁突发育及畸形的调控机制研究进展

doi:10.3969/j.issn.1674-8115.2024.08.003

上海交通大学学报（医学版） ›› 2024, Vol. 44 ›› Issue (8): 951-958.doi: 10.3969/j.issn.1674-8115.2024.08.003

下颌髁突发育及畸形的调控机制研究进展

刘旌毅(), 徐弘远, 代庆刚, 江凌勇()

上海交通大学医学院附属第九人民医院口腔颅颌面科，上海交通大学口腔医学院，国家口腔医学中心，国家口腔疾病临床医学研究中心，上海市口腔医学重点实验室，上海市口腔医学研究所，上海 200011

收稿日期:2024-02-21 接受日期:2024-07-19 出版日期:2024-08-28 发布日期:2024-08-27
通讯作者: 江凌勇 E-mail:liujy0406@sjtu.edu.cn;jianglingyong@sjtu.edu.cn
作者简介:刘旌毅（1998—），男，博士生；电子信箱：liujy0406@sjtu.edu.cn。
基金资助:
国家自然科学基金(82071083);中央高校基本科研业务费专项资金(YG2023ZD14);上海交通大学医学院“双百人”项目(20221809);上海市自然科学基金(21ZR1436900);上海市“科技创新行动计划”国际科技合作项目/政府间国际科技合作项目(23410713600);上海交通大学医学院附属第九人民医院交叉研究基金(JYJC202116);上海交通大学医学院生物材料与再生医学交叉研究项目(2022LHB02);上海交通大学医学院附属第九人民医院原创项目(JYYC003)

Progress in the regulatory mechanisms of mandibular condylar development and deformity

LIU Jingyi(), XU Hongyuan, DAI Qinggang, JIANG Lingyong()

Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai 200011, China

Received:2024-02-21 Accepted:2024-07-19 Online:2024-08-28 Published:2024-08-27
Contact: JIANG Lingyong E-mail:liujy0406@sjtu.edu.cn;jianglingyong@sjtu.edu.cn
Supported by:
National Natural Science Foundation of China(82071083);Fundamental Research Funds for the Central Universities(YG2023ZD14);“Two-Hundred Talent” Project of Shanghai Jiao Tong University School of Medicine(20221809);Natural Science Foundation of Shanghai(21ZR1436900);Shanghai Science and Technology Innovation Action Plan—International Science and Technology Cooperation Program(23410713600);Cross-Disciplinary Research Fund of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine(JYJC202116);Biomaterials and Regenerative Medicine Institute Cooperative Research Project, Shanghai Jiao Tong University School of Medicine(2022LHB02);Original Exploration Project of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine(JYYC003)

摘要/Abstract

摘要：

颞下颌关节是颅颌面骨骼系统中的唯一关节结构，负责执行日常生活中咀嚼、说话、表情等涉及张口、闭口的功能。下颌髁突作为颞下颌关节中的关键组成部分，起源于第一鳃弓所形成的下颌突，是下颌骨升支末端的关键生长中心。髁突由表面覆盖的软骨层和下方的软骨下骨组成，在生长发育的过程中具有独特的生物学过程。髁突的功能性运动依赖于其正常的生理解剖结构，对咬合的建立及面容的塑造起到关键作用。生长发育异常可导致髁突畸形的发生，通过影响患者的颌面部垂直向高度，最终引发不同程度的继发性骨性Ⅱ类或Ⅲ类颅颌面畸形。在生长发育的过程中，髁突受到复杂的信号调控作用。近年来，随着对颞下颌关节研究的深入，研究者开始从基因表达和分子水平的角度讨论髁突生长发育的调控机制，以解释颞下颌关节疾病以及髁突畸形的发生原因。该文就髁突的生发过程和结构、髁突畸形分类与病理表现、髁突生长发育中的信号调控及髁突畸形的致病机制作一综述，期望为临床上因下颌髁突发育异常导致的颞下颌关节疾病及颅颌面畸形的治疗提供研究思路。

关键词: 髁突, 生长发育, 畸形, 调控机制, 骨重塑

Abstract:

The temporomandibular joint is the only joint structure within the craniofacial skeletal system, responsible for performing functions related to opening and closing mouth movements, such as chewing, speaking, and facial expression in daily life. The condyle of the mandible, as a vital component of the temporomandibular joint, originates from the mandibular process formed by the first gill arch and is the key growth center at the end of the mandibular ramus. Condyle is composed of a layer of cartilage as its surface and subchondral bone below, exhibiting unique biological processes during its growth and development. In the articular fossa, the functional movement of the condyle depends on its normal physiological and anatomical structure, which plays a crucial role in establishing occlusion and shaping facial features. Abnormal growth and development can lead to the occurrence of condylar deformities, which affect the vertical height of the patient's maxillofacial region and ultimately lead to secondary skeletal class Ⅱ or Ⅲ craniofacial deformities. During the process of growth and development, the condyle is subject to complex signal regulation. In recent years, with in-depth research on the temporomandibular joint, researchers have begun to discuss the regulatory mechanisms of condyle growth and development from the perspectives of gene expression and molecular level, in order to explain the causes of temporomandibular joint diseases and condylar deformities. This article provides a review on the growth process and structure of condyle, classification and pathological manifestations of condylar deformities, and related regulatory mechanisms of the growth and development of condyle, as well as pathogenesis of condylar deformities. The aim of this article is to provide research ideas for temporomandibular joint diseases and craniofacial malformations caused by abnormal development of the mandibular condyle in clinical practice.

Key words: condyle, growth and development, deformity, regulatory mechanism, bone remodeling

中图分类号:

R782.6

刘旌毅, 徐弘远, 代庆刚, 江凌勇. 下颌髁突发育及畸形的调控机制研究进展[J]. 上海交通大学学报（医学版）, 2024, 44(8): 951-958.

LIU Jingyi, XU Hongyuan, DAI Qinggang, JIANG Lingyong. Progress in the regulatory mechanisms of mandibular condylar development and deformity[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(8): 951-958.

图/表 3

图1 髁突的结构示意图

Fig 1 Schematic diagram of the histological structure of the condyle

表1 髁突软骨与长骨关节软骨的区别

Tab 1 Comparison between condylar cartilage and long bone articular cartilage

Characteristic	Condylar cartilage	Long bone articular cartilage
Type	Fibrocartilage	Hyaline cartilage
Classification	Secondary cartilage	Primary cartilage
Main collagen type	Collagen type Ⅰ, Ⅱ, Ⅲ, and Ⅹ	Collagen type Ⅱ, Ⅲ, and Ⅹ
Collagen arrangement direction	Front-to-back direction	Reticular crossing

图2 髁突生长发育中的信号调控示意图Note： SOST—sclerostin; MMP13—matrix metalloproteinases-13. Solid lines represent cell differentiation and cartilage matrix generation; dashed lines represent the promoting effect on cell differentiation.

Fig 2 Schematic diagram of signal regulation during condylar growth and development

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下颌髁突发育及畸形的调控机制研究进展

Progress in the regulatory mechanisms of mandibular condylar development and deformity

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