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Kim PJ, Skabelund Z, Kalim S, Lee CH, Kim N, Nguyen K, Emam H, Knobloch L, Deguchi T, Kim M, Kim DG. Sex dependent differences of temporomandibular condylar bone mineral density distribution. Cranio 2022:1-7. [PMID: 36302258 DOI: 10.1080/08869634.2022.2137131] [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: 10/31/2022]
Abstract
OBJECTIVE The objective of this study was to examine whether bone mineral density (BMD) distribution in the mandibular condyle and facial morphology are associated with temporomandibular joint osteoarthritis (TMJ OA) using clinical cone beam computed tomography (CBCT) images. METHODS CBCT images of 35 adults (16 male and 19 female) were examined to obtain TMJ OA counts, cephalometric analyses, and histograms of gray values that are proportional to BMD. Mean, standard deviation (SD), and low and high gray values at the 5th and 95th percentiles (Low5 and High5) of the histograms were measured. RESULTS The female group had significantly higher values of TMJ OA counts, mean, and SD on the right mandibular condyle, High5 on both sides, and all gray value parameters for total (right + left) than the male group. CONCLUSION Comprehensive analysis of BMD distribution in the mandibular condyle can provide useful information for prognosis of TMJ OA.
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Affiliation(s)
- Paul J Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Zachary Skabelund
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Sonya Kalim
- Division of Oral & Maxillofacial Radiology, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Christine H Lee
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Nathan Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Kristen Nguyen
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Hany Emam
- Division of Oral and Maxillofacial Surgery and Anesthesiology, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Lisa Knobloch
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Toru Deguchi
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Minji Kim
- Department of Orthodontics, Graduate School of Clinical Dentistry, Ewha Womans University, Seoul, Korea
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
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Liu J, Watanabe K, Dabdoub SM, Lee BS, Kim DG. Site-specific characteristics of bone and progenitor cells in control and ovariectomized rats. Bone 2022; 163:116501. [PMID: 35872108 DOI: 10.1016/j.bone.2022.116501] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 11/25/2022]
Abstract
One-third of postmenopausal women experience at least one osteoporotic bone fracture in their lifetime that occurs spontaneously or from low-impact events. However, osteoporosis-associated jaw bone fractures are extremely rare. It was also observed that jaw bone marrow stem cells (BMSCs) have a higher capacity to form mineralized tissues than limb BMSCs. At present, the underlying causes and mechanisms of variations between jaw bone and limb bone during postmenopause are largely unknown. Thus, the objective of the current study was to examine the site-specific effects of estrogen deficiency using comprehensive analysis of bone quantity and quality, and its association with characterization of cellular components of bone. Nine rats (female, 6 months old) for each bilateral sham and ovariectomy (OVX) surgery were obtained and maintained for 2 months after surgery. A hemi-mandible and a femur from each rat were characterized for parameters of volume, mineral density, cortical and trabecular morphology, and static and dynamic mechanical analysis. Another set of 5 rats (female, 9 months old) was obtained for assays of BMSCs. Following cytometry to identify BMSCs, bioassays for proliferation, and osteogenic, adipogenic, chondrogenic differentiation, and cell mitochondrial stress tests were performed. In addition, mRNA expression of BMSCs was analyzed. OVX decreased bone quantity and quality (mineral content, morphology, and energy dissipation) of femur while those of mandible were not influenced. Cellular assays demonstrated that mandible BMSCs showed greater differentiation than femur BMSCs. Gene ontology pathway analysis indicated that the mandibular BMSCs showed most significant differential expression of genes in the regulatory pathways of osteoblast differentiation, SMAD signaling, cartilage development, and glucose transmembrane transporter activity. These findings suggested that active mandibular BMSCs maintain bone formation and mineralization by balancing the rapid bone resorption caused by estrogen deficiency. These characteristics likely help reduce the risk of osteoporotic fracture in postmenopausal jawbone.
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Affiliation(s)
- Jie Liu
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Keiichiro Watanabe
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Shareef M Dabdoub
- Division of Biostatistics and Computational Biology, Department of Periodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA 52242, USA.
| | - Beth S Lee
- Department of Physiology and Cell Biology, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA.
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Characterization of Non-Invasively Induced Post-Traumatic Osteoarthritis in Mice. Antioxidants (Basel) 2022; 11:antiox11091783. [PMID: 36139857 PMCID: PMC9495497 DOI: 10.3390/antiox11091783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022] Open
Abstract
The pathophysiology of post-traumatic arthritis (PTOA) is not fully understood. This study used non-invasive repetitive mechanical loading (ML) mouse models to study biochemical, biomechanical, and pain-related behavioral changes induced in mice. Mouse models reflected the effects of the early stages of PTOA in humans. For the PTOA model, cyclic comprehensive loading (9N) was applied to each mouse’s left knee joint. ML-induced biochemical and molecular changes were analyzed after loading completion. Cartilage samples were examined using gene expression analysis. Tissue sections were used in subsequent OA severity scoring. Biomechanical features and pain-related behavior were studied after 24 h and three weeks post-ML sessions to examine the development of PTOA. The loaded left knee joint showed a greater ROS/RNS signal than the right knee, which was not loaded. There was a significant increase in cartilage damage and MMP activity in the mechanically loaded joints relative to non-loaded control knee joints. Similarly, we found a difference in the viscoelastic tangent, which highlights significant changes in mechanical properties. Biochemical analyses revealed significant increases in total NO, caspase-3 activity, H2O2, and PGE2 levels. Gene expression analysis highlighted increased catabolism (MMP-13, IL-1β, TNF-α) with a concomitant decrease in anabolism (ACAN, COL2A1). Histopathology scores clearly indicated increases in OA progression and synovitis. The gait pattern was significantly altered, suggesting signs of joint damage. This study showed that biomechanical, biochemical, and behavioral characteristics of the murine PTOA groups are significantly different from the control group. These results confirm that the current mouse model can be considered for translational PTOA studies.
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Hong SW, Kang JH. Relationship between skeletal bone mineral density and subjective masticatory difficulty. BMC Oral Health 2022; 22:136. [PMID: 35448990 PMCID: PMC9027039 DOI: 10.1186/s12903-022-02172-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Masticatory ability is an essential factor for sustaining quality of life and social and systemic well-being, particularly in elderly. This study aimed to reveal the association between subjective masticatory difficulty and skeletal bone mineral density (BMD). Methods Data from the Korean National Health and Nutrition Examination Survey, which was conducted from 2008 to 2011 were analyzed. This study included 13,092 Koreans (5656 males, 7436 females) over 50 years of age. Masticatory difficulty was evaluated based on a self-reported questionnaire. Areal BMD of the total hip, femoral neck, and lumbar spine as well as lean body mass were determined using dual-energy X-ray absorptiometry. Data about the sociodemographic characteristics, physical activity, number of teeth present, sum of decayed, missing, and filled permanent teeth (DMFT) index and Community Periodontal Index (CPI) were collected. Multivariate logistic regression analysis was conducted to analyze associations between subjective masticatory difficulty and BMD, adjusting for the confounding covariates. Results Significant differences were observed in the areal BMD of the total hip, femoral neck, and lumbar spine as well as lean body mass accordance with the presence of subjective masticatory difficulty in both males and females. The number of teeth, DMFT, and CPI score did not show significant differences based on the presence of self-reported satisfaction of chewing performance in both males and females. Results from multivariate logistic regression demonstrated that the subjective masticatory difficulty showed significant interactions with skeletal BMD and the associations between masticatory satisfaction and BMD of the total hip and femoral neck were more prominent in females compared to those in males. Conclusions The skeletal BMD, particularly areal BMD of the femoral neck was significantly associated with subjective masticatory difficulty in elderly, especially in elder females.
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Affiliation(s)
- Seok Woo Hong
- Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea
| | - Jeong-Hyun Kang
- Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea.
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A review of composition‐structure‐function properties and tissue engineering strategies of articular cartilage: compare condyle process and knee‐joint. ADVANCED ENGINEERING MATERIALS 2022. [DOI: 10.1002/adem.202200304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Liu J, Kim EK, Ni A, Kim YR, Zheng F, Lee BS, Kim DG. Multiscale characterization of ovariectomized rat femur. J Biomech 2021; 122:110462. [PMID: 33915473 DOI: 10.1016/j.jbiomech.2021.110462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 02/12/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
Estrogen deficiency activates bone resorbing cells (osteoclasts) and to a lesser extent bone forming cells (osteoblasts), resulting in a gap between resorption and formation that leads to a net loss of bone. These cell activities alter bone architecture and tissue composition. Thus, the objective of this study is to examine whether multiscale (10-2 to 10-7 m) characterization can provide more integrated information to understand the effects of estrogen deficiency on the fracture risk of bone. This is the first study to examine the effects of estrogen deficiency on multiscale characteristics of the same bone specimen. Sprague-Dawley female rats (6 months old) were obtained for a bilateral ovariectomy (OVX) or a sham operation (sham). Micro-computed tomography of rat femurs provided bone volumetric, mineral density, and morphological parameters. Dynamic mechanical analysis, static elastic and fracture mechanical testing, and nanoindentation were also performed using the same femur. As expected, the current findings indicate that OVX reduces bone quantity (mass and bone mineral density) and quality (morphology, and fracture displacement). Additionally, they demonstrated reductions in amount and heterogeneity of tissue mineral density (TMD) and viscoelastic properties. The current results validate that multiscale characterization for the same bone specimen can provide more comprehensive insights to understand how the bone components contributed to mechanical behavior at different scales.
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Affiliation(s)
- Jie Liu
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA; Division of Restorative Science and Prosthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Eun Kyoung Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Ai Ni
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Yong-Rak Kim
- Zachry Department of Civil & Environmental Engineering, Texas A&M University, College Station, TX, USA
| | - Fengyuan Zheng
- Division of Restorative Science and Prosthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Beth S Lee
- Department of Physiology and Cell Biology, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA.
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Bhatti FUR, Karydis A, Lee BS, Deguchi T, Kim DG, Cho H. Understanding Early-Stage Posttraumatic Osteoarthritis for Future Prospects of Diagnosis: from Knee to Temporomandibular Joint. Curr Osteoporos Rep 2021; 19:166-174. [PMID: 33523424 DOI: 10.1007/s11914-021-00661-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Many mechanical load-bearing joints of the body are prone to posttraumatic osteoarthritis (PTOA), including the knee joint and temporomandibular joint (TMJ). Early detection of PTOA can be beneficial in prevention or alleviating further progression of the disease. RECENT FINDINGS Various mouse models, similar to those used in development of novel diagnosis strategies for early stages of OA, have been proposed to study early PTOA. While many studies have focused on OA and PTOA in the knee joint, early diagnostic methods for OA and PTOA of the TMJ are still not well established. Previously, we showed that fluorescent near-infrared imaging can diagnose inflammation and cartilage damage in mouse models of knee PTOA. Here we propose that the same approach can be used for early diagnosis of TMJ-PTOA. In this review, we present a brief overview of PTOA, application of relevant mouse models, current imaging methods available to examine TMJ-PTOA, and the prospects of near-infrared optical imaging to diagnose early-stage TMJ-OA.
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Affiliation(s)
- Fazal-Ur-Rehman Bhatti
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Research 151, VAMC, 1030 Jefferson Ave, Memphis, TN, 38104 , USA
| | - Anastasios Karydis
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Research 151, VAMC, 1030 Jefferson Ave, Memphis, TN, 38104 , USA
| | - Beth S Lee
- Department of Physiology and Cell Biology, College of Medicine, The Ohio State University , Graves Hall, 333 West 10th Avenue, Columbus, OH, 43210, USA
| | - Toru Deguchi
- Division of Orthodontics, College of Dentistry, The Ohio State University, 4088 Postle Hall, 305 W. 12th Ave., Columbus, OH, 43210, USA
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, 4088 Postle Hall, 305 W. 12th Ave., Columbus, OH, 43210, USA.
| | - Hongsik Cho
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Research 151, VAMC, 1030 Jefferson Ave, Memphis, TN, 38104 , USA.
- Campbell Clinic, Memphis, TN, USA.
- Veterans Affairs Medical Center, Memphis, TN, USA.
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Watanabe K, Lewis S, Guo X, Ni A, Lee BS, Deguchi T, Kim DG. Regional variations of jaw bone characteristics in an ovariectomized rat model. J Mech Behav Biomed Mater 2020; 110:103952. [PMID: 32957244 DOI: 10.1016/j.jmbbm.2020.103952] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/21/2020] [Accepted: 06/22/2020] [Indexed: 12/22/2022]
Abstract
Postmenopausal osteoporosis causes severe loss of bone quantity and quality in limb bone but has a lesser effect on jaw bone. Thus, the objective of this study was to examine whether ovariectomy (OVX) and mastication alter the regional variation of jaw bone characteristics. Sprague-Dawley female rats (6 months) were given a bilateral OVX or a sham operation (SHAM) (n = 10 for each group). After 2 months post-OVX, the hemi-mandible from each rat was dissected. A micro-computed tomography based mean, standard deviation (SD), the lower and upper 5th percentile (Low5 and High5) values of tissue mineral density (TMD) histograms were assessed for whole bone (WB), alveolar bone (AB), cortical bone (CB), and trabecular bone (TB) regions. Morphology of TB and periodontal ligament (PDL) was also obtained. Layers of AB were segmented up to 400 μm from the PDL. Mechanical properties at the tissue level were measured by nanoindentation at the same site by a single loading-unloading cycle of indentation in hydration. The AB and TB regions had significantly lower TMD Mean, Low5, and High5 but higher SD than the CB region for both sham and OVX groups (p < 0.01). TMD parameters of the OVX group rapidly increased up to 60 μm away from the PDL and were significantly higher than those of the sham group starting at 280 μm and farther in the CB region (p < 0.05). All values of morphological and nanoindentation parameters were not significantly different between sham and OVX groups (p > 0.06). Estrogen deficiency induced by OVX did not deteriorate bone characteristics including mineral density, morphology, and nanoindentation parameters in rat mandibles. Masticatory loading had an effect on the TMD parameters at the limited region of AB. These results provide insight into why osteoporosis-associated jaw bone fractures are extremely rare.
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Affiliation(s)
- Keiichiro Watanabe
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, 43210, USA
| | - Samantha Lewis
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, 43210, USA
| | - Xiaohan Guo
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, 43210, USA
| | - Ai Ni
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, 43210, USA
| | - Beth S Lee
- Department of Physiology and Cell Biology, College of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Toru Deguchi
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, 43210, USA
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, 43210, USA.
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Estrogen signaling impacts temporomandibular joint and periodontal disease pathology. Odontology 2019; 108:153-165. [PMID: 31270648 DOI: 10.1007/s10266-019-00439-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/16/2019] [Indexed: 12/12/2022]
Abstract
Women experience a higher incidence of oral diseases including periodontal diseases and temporomandibular joint disease (TMD) implicating the role of estrogen signaling in disease pathology. Fluctuating levels of estrogen during childbearing age potentiates facial pain, high estrogen levels during pregnancy promote gingivitis, and low levels of estrogen during menopause predisposes the TMJ to degeneration and increases alveolar bone loss. In this review, an overview of estrogen signaling pathways in vitro and in vivo that regulate pregnancy-related gingivitis, TMJ homeostasis, and alveolar bone remodeling is provided. Deciphering the specific estrogen signaling pathways for individual oral diseases is crucial for potential new drug therapies to promote and maintain healthy tissue.
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Kretschmer WB, Baciuţ G, Baciuţ M, Sader R. Effect of bimaxillary orthognathic surgery on dysfunction of the temporomandibular joint: a retrospective study of 500 consecutive cases. Br J Oral Maxillofac Surg 2019; 57:734-739. [PMID: 31255372 DOI: 10.1016/j.bjoms.2019.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 06/16/2019] [Indexed: 10/26/2022]
Abstract
We investigated the effect of bimaxillary orthognathic surgery on symptoms in the temporomandibular joint (TMJ) and predictive factors for postoperative dysfunction. A total of 500 patients with different craniofacial deformities who were having bimaxillary orthognathic surgery were assessed for overjet, overbite, maximal mouth opening, maximal protrusion, maximal lateral movement to both sides, and symptoms of TMJ dysfunction (pain on palpation, clicking, or crepitus) before operation and one year postoperatively. The panoramic radiographs taken on the same dates were assessed for reduction in the height of the ramus. Other variables were age, sex, segmentation of the maxilla, and additional genioplasty. Changes in the symptoms of dysfunction were investigated with the McNemar test. Measurements of the maximum mandibular movements taken preoperatively and postoperatively were compared using the paired t test. Multivariate logistic regression was used to assess the influence of the variables on symptoms preoperatively and postoperatively. The effect of occlusal stability (overjet and overbite) on postoperative symptoms in the TMJ was investigated with the unpaired t test. Women and class II patients had significantly more pain on palpation preoperatively, and a significant reduction in pain on palpation and clicking after operation. Predictive factors were preoperative crepitus for postoperative pain, and preoperative clicking for postoperative clicking. Patients with and without symptoms showed no significant differences in overjet and overbite postoperatively. Condylar resorption was found in 29 patients (5.8 %), and only 14 of them had symptoms in the TMJ. In patients with no preoperative symptoms or radiological abnormalities of the condyle, condylar resorption was rare (0.8 %). Orthognathic surgery has a beneficial effect on dysfunction of the TMJ as it reduces pain and clicking considerably. Patients should be informed, however, that TMJ disorders could still develop even if they had no symptoms preoperatively.
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Affiliation(s)
- W B Kretschmer
- Department of Head-, Neck- and Facial Plastic Surgery, Medius Klinik Ostfildern-Ruit, Germany.
| | - G Baciuţ
- Department of Cranio-Maxillofacial Surgery, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - M Baciuţ
- Department of Cranio-Maxillofacial Surgery, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - R Sader
- Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University, Frankfurt, Germany
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